Airlift a patient only after weighing its advantage: DGCA

A decision on airlifting a patient should be taken after weighing its advantage against potential complications during transportation, the Directorate General of Civil Aviation (DGCA) has said.

According to a new Civil Aviation Requirement (CAR) that will come into effect from May 1, the type of aircraft and the composition of the medical team accompanying the patient should also be determined by the clinical condition of the patient and the distance to be moved.

Careful medical direction and medical control for planning and preparation should be exercised during Aero Medical Transport (AMT) and “contraindications” should be anticipated, it said. Contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient

The new rule said the AMT should offer a “clear advantage” to the patient since this is a “major value judgment” and should be made only after a “thorough assessment of the medical benefits” for the patient.

“This will often be obvious when sophisticated medical care is required urgently but sometimes the speed advantage of AMT has to be weighed against the benefits of maintaining medical care on the ground and the potential complications during transportation,” the CAR said.

Patients should be “reassessed regularly” throughout the AMT since there are specific risks inherent in aeromedical flight which interact with medical status. These are related to physical properties of flight and associated factors, which include reduced atmospheric pressure, decreased oxygen tension, dehydration, motion sickness, vibration, noise and inactivity.

The rule said the airline operators who choose to conduct Air Ambulance services should obtain acceptance from DGCA prior to conduct of such a service which shall be operated under provisions for commercial air transport operations.

Single engine aircraft could be used for air ambulance role and it should be designed and maintained in a safe and sanitary condition. It should  have an access large enough to allow a stretcher to be loaded without rotating it more than 30 degrees about the longitudinal axis or 30 degrees about the lateral axis.

The air ambulance should also have climate control in the cabin of the aircraft to prevent extremes of temperature and humidity that would adversely affect the care of a patient or medical supplies. Such a requirement may be waived off in case of medical personnel transfer, the new rule said.

(An edited version appeared in Deccan Herald on Feb 23, 2016)

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