Advanced Paramedic Ltd. (APL) provides 24/7 air ambulance services for Canada’s Alberta Health Service. Working aboard specially outfitted fixed-wing aircraft, experienced paramedics care for critically ill patients during inter-hospital transport and/or for emergency care. The high-acuity planes serve as compact mobile ICUs or ERs, ensuring advanced medical care while in flight.
“Much of our work is hospital-to-hospital transfers, mainly for rural medical facilities that can’t handle major medical events. Helping to stabilize seriously ill patients, we quickly and safely transport them to higher levels of care at trauma or stroke centers that can be hundreds of miles away.”
The ability to rapidly adjust the course of therapy while in the air can be a matter of life or death. Point-of-care testing (POCT) has become a vital tool for airborne critical care transport teams such as APL, informing them of up-to-the-minute changes in the physical and mental conditions of their patients.1 The team now conducts blood gas, electrolyte, and metabolite testing at the patient’s side with the handheld, wireless epoc® Blood Analysis System. Analysis of blood gases in particular plays a significant role in changing the course of ventilator therapy in flight: approximately 30 percent of the patients APL transports are intubated. Each APL air ambulance typically covers a 200-km (124-mile) radius. Their transport times average 1–2 hours, but some flights have taken as long as 4–6 hours. From takeoff to landing, sky paramedics are responsible for delivering advanced, if not lifesaving, care.
Transforming Care Delivery
More than 70% of medical decision making relies on laboratory test results.2 In prehospital settings, POCT aids in providing stabilizing care and immediately intervening to save lives and improve patient outcomes.2 From hospital pickup to receiving hospital handoff, the APL air ambulance team uses local hospital lab results when available and may perform full-panel patient-side testing using the epoc system as many as four times during a single trip.
“We have seen clinical improvements after we adjusted the ventilator settings based on epoc test results while onboard the plane.”
“While we aren’t with patients long enough to see reductions in mortality or days on a ventilator,” says Rideout, “we have seen clinical improvements after we adjusted the ventilator settings based on epoc test results while onboard the plane.” Thanks to the extensive testing capabilities of the epoc system, APL has contributed to improving patient safety and treatment as well as enhancing workflow for receiving hospitals.
The ability to monitor patients during air ambulance transport with blood gas, electrolyte, and metabolite results available in less than a minute enables adjustment of ventilator settings and clinical improvement. Inventory management is streamlined, with 13 test results available on a single, bar-coded, room temperature-stable test card. The reliability of the easy-to-use epoc system frees the transport team to focus on patient care.