High Flying Ambulances
Image from flightaware . com by TOM JAMES , MD
This was to be a final fun vacation for Natalie , her husband Jordan , and their 8-year-old son , Ethan . Natalie was 31 weeks pregnant when the family left their Louisville home to drive west . The family felt this trip would allow Ethan a chance to travel before the new baby would arrive in a few months . Natalie ’ s obstetrician had advised her that since she had no risk factors , it was probably safe to travel , but to be sure to return to Louisville by 35 weeks . 1 It was an unhurried drive as the family headed west . Everyone needed time to stretch their legs . They were on the eight hour stretch between Mount Rushmore and the Grand Tetons when Natalie ’ s water broke . Somewhat panicked , the family went to the closest hospital to their route in rural Wyoming . There , Natalie was evaluated and with a positive ferning test , they found that she had actual ruptured membranes . The hospital did not have a neonatal intensive care unit or any neonatologists . After being put on bed rest , the local pediatrician advised Natalie and Jordan that she needed to be transported to a hospital capable of managing a 32-week premature infant . After calls to her Louisville obstetrician , it was decided to have her come back by fixed-wing “ air ambulance .” This way she could be in a hospital where her obstetrical status could be closely monitored with delivery at the most appropriate time . The new baby could receive high level
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NICU care . So after receiving steroids , antibiotics and magnesium , the arrangements were made for a medically equipped jet to take her with a flight nurse on the three-hour flight to Louisville . Once on the ground , a surface ambulance took Natalie to the hospital . All turned out well as Natalie was monitored and delivered at an optimal time . The baby spent time in the NICU before returning home … and Jordan and Ethan had an uneventful return from Wyoming in the family car .
In the past , air ambulance trips were most common for acute medical or surgical emergencies , for example , a patient who was in an auto accident in a location where surface ambulances could not reach . Air ambulances are often used when time is critical and travel by air is significantly faster than surface ambulances . Helicopters typically travel short distances . For longer trips , fixed-wing aircraft better serve patient care .
Increasingly , fixed-wing air ambulances are called for urgent but non-emergent transport of patients such as Natalie where appropriate care is not immediately accessible and where there is time to do initial assessment and treatment before getting the patient to the most appropriate setting . Air transport may be appropriate for infants and children with complex congenital issues if there are only a limited number of centers that can handle their problems . In a similar fashion , air ambulances may be a safer option for the immunocompromised transplant patient for urgent re-evaluation