Medical evacuation by aircraft, known as medevac, is the timely movement and enroute care of injured or sick people from one location to another. Doctors and medical assistants involved in medevac are known as aeromedical crew. They are usually from land-based medical backgrounds, and the equipment they use airborne is very similar to ground-based equipment. This article explains how medically trained individuals can exchange their down time for some paid up time.
Medevac encompasses emergency and elective (pre-planned) transportation, examples span: Emergency Medical Services (EMS) from the scene of an accident to a receiving medical facility (eg: by helicopter), repatriation from a distant location back home to a medical facility (eg: by business jet), and patient transfer between medical facilities where distances are great, or when transfer times must be minimised for patients in need of critical care (eg: by business jet or turbo-prop aircraft).
The concept of using aircraft as ambulances is almost as old as powered flight itself. The movement of patients by air dates to World War I. The first Air Ambulance flight was performed by the French Air Service carrying a Serbian officer from the battlefield to hospital. Interestingly, French records at that time indicate that the mortality rate of the injured was reduced from 60% to just under 10% if they were evacuated by air.
Subsequently, civilian "bush" pilots flying small aircraft into isolated areas began carrying doctors and nurses. In the 1920s and 1930s, Sweden, Thailand, Australia, Morocco and Scotland all established standing air ambulance systems. Today in the US, helicopters and fixed-wing airplanes carry out approximately 500,000 medevacs per year.
Air ambulance services are provided by a mixture of organisations spanning benevolent (eg: Save the Children, Medecins Sans Frontieres), fee-for-service, and government contracts. Helicopters are slow (200 kmh) and short range (200 km) but they can gain better access to accident scenes. Fixed-wing aircraft (eg: business jets and propeller driven aircraft) are faster (300 to 800 kmh) and can fly much further (1000-20000km) but they need to operate from airports. Therefore, helicopters are typically used for Emergency Medical Services (EMS) as first response at trauma scenes, and fixed-wing for other tasks such as patient transfer or repatriation, providing regional and international response.
All aeromedical personnel start on the ground and are from land-based medical backgrounds. Sadly, many land-based medical staff are simply unaware of the enormous scope for freelance work in the medevac sector. They are uninformed of the straightforward aeromedical conversion that can be achieved to bring their skills into the air. The result: numerous Airborne Medical Evacuation flights are rescheduled or cancelled due to insufficient aeromedical staff.
Ground-based medical and paramedical staff who have downtime can relatively quickly and simply augment their skills, experience and income. If you enjoy travelling, working as a team, and are competent with your land-based medical skills then this is for you.
Through a relatively short and straightforward conversion (as short as a few hours with instructional video and aircraft cabin familiarisation), you can help ease the global shortage of aeromedical crews and improve the level of healthcare provided worldwide.
Sign up for free: If you are a doctor, nurse, paramedic or healthcare professional, and you enjoy working in a rewarding and often exciting sector whilst travelling globally, then sign up with Freelance Aircrew and exchange your down-time for some paid up-time.
Onboard, there are typically two aeromedical crew - a doctor and a nurse/paramedical assistant. The airborne relationship is very similar to the ground-based relationship. There is a little less space and the team need to be able to work autonomously for short periods of time.
Aeromedical crews provide comprehensive emergency and/or elective care to all types of patients during medevac. The role of the aeromedical crew depends on the type of air ambulance operator and the service being offered. At the extreme end of the spectrum, is an Emergency Medical Service. Typically, helicopter based responding to serious accidents, trauma incidents and emergency critical care need. Emergency doctors and nurses, anaesthetists and intensive care nurses, Cardiologists, medical staff who have worked in military operations, paramedics, and first responders are most suited to this type of work.
The transport of critically ill patients on artificial ventilation makes up 10-20% of air ambulance flights. Therefore, specialist doctors such as anaesthetists (aka anaesthesiologists) and intensive care doctors, along with anaesthetic nurses and intensive care nurses, are in demand. The lion’s share of air ambulance operations and medical escort duties involve elective patients (adult and paediatric) being transferred between units or repatriated. This work calls for all kinds of medical personnel, generalists and specialists.
In short, all types of patients adult and paediatric emergency and elective need to be transported. Some medevac roles are arguably more demanding than others; transporting critically ill and emergency status patients is at the extreme end of the medevac spectrum. However, the larger market involves the repatriation of injured or sick but stable patients. Bottom line: Medevac offers something for all types of medical personnel and all levels of qualification and experience.
Aeromedical staff are quickly converted from ground-based work to airborne work. The conversion can be as short as two hours of ground-based instruction (a video on airborne differences and altitude considerations, and then a cabin familiarisation in the aircraft). The key is to be able to work as a team and in the special confines of an aircraft.
Pay can be generous depending on experience and expertise. The Web-App allows you to specify a daily rate. Typically, service providers pay staff for days away from home, and cover positioning and per diems including accommodation. In addition, training costs for courses such as ATLS and aeromedical specific training are often included in the package.
Sign up for free: If you are a doctor, nurse, paramedic or healthcare professional, and you enjoy working in a rewarding and often exciting sector whilst travelling globally, then sign up with Freelance Aircrew and exchange your down-time for some paid up-time.
In broad terms, the key differences between ground-based and airborne healthcare are: aeromedical staff work in a less spacious environment, and they must be self-reliant given the implicit lack of support when in the air. Good social skills and flexibility are valued traits. When airborne, there are nominally only two care providers so both doctor and assistant must be Advanced Trauma Life Support (ATLS) qualified or possess an equivalent advanced life support training certificate refreshed annually. Typically, ATLS training lasts a couple of days and operators often provide accredited training onsite.
Aeromedical specific training focuses on adapting to the physical environment of the aircraft, and understanding the physiological impact of altitude; most modern jets and turbo-prop aircraft have a long-range cruise cabin altitude of less than 7000 feet and are often capable of maintaining the altitude down to 4000 feet or lower. Being above sea-level means there is less oxygen in the cabin atmosphere. Fit human beings experience nil or very minor effects below 10,000 feet. However, some patients may require supplemental oxygen depending on their condition. Aeromedical crews discuss with their pilots and agree what altitude the cabin should be at. If required, the cabin altitude can often be brought down to sea-level.
Therefore, aeromedical conversion training for fixed-wing transport can be achieved relatively quickly with a short period of ground-based instruction.
All aeromedical personnel start on the ground and are from land-based medical backgrounds. Therefore, the medical equipment used airborne is identical or very similar to ground-based equipment. Space may be more of a premium so aeromedical training is more about adapting to the surroundings.
You can specify how far you are prepared to travel. Helicopter based medevac flights are often local (within 200 km of base), fixed wing flights venture much further afield (from 200km to 20000km) across countries and continents. Air Ambulance operators will position you to the start point and recover you to your home base after working. Normally, this is achieved through commercial aviation or empty legs on business jets.
Medicolegal issues in aeromedical transport (such as jurisdiction, importation and exportation of drugs, international health regulations, and certification of births and deaths) can be complex. Therefore, aeromedical personnel must have adequate malpractice insurance cover. Dependent on the qualifications of aeromedical staff, Air Ambulance companies often provide blanket insurance policies to cover these complexities.
A simple concept, Freelance Aircrew have created a website that brings together medical personnel and Air Ambulance operators in a timely manner. Medical personnel provide their qualifications and availability forming a large global database covering all specialities. The website prompts personnel with reminders, and enables air ambulance operators to search for matches to global tasks. Search criteria can be based on geography, dates and qualifications – operators can quickly check online the qualifications, vaccinations, passport details, visas, language skills, experience, references, and location of aeromedical staff.
Given that nearly 100% of the global medical fraternity have access to the internet today, it was logical to create a web-based facility that hosted medical staff, their qualifications, languages, visas, inoculations, preferences, references and availability – providing medical staff with prompts and reminders to update their information. This global database paired with Air Ambulance providers’ search requirements means that freelancers and operators can quickly find each other. Freelance Aircrew replaces out of date handwritten phone lists and spreadsheets, typically held by companies and hospitals, at a tiny fraction of the cost of home grown HR, providing a highly cost-effective surge and short-term HR function for operators, aeromedical crew, pilots and flight attendants.
The Freelance Aircrew team are experienced Royal Air Force pilots, specialist aeromedical doctors and entrepreneurs with distinguished careers in critical-care and hostile operating environments. The delivery of services within severe time pressures to exacting standards is what they do. Identifying the lack of medical personnel in the sector, the team has just launched a brand-new facility that provides surge, short-term and long-term HR management for Air Ambulance Services.
One could draw parallels with the arguably successful concepts of Uber, AirBnB and even Moonpig. Whatever those companies’ critics say, it is hard to deny that the Silicon Valley Upstarts have created a new wave of productivity and furthered human connectivity. Freelance Aircrew plan to use this productivity and connectivity within a regulated medical framework to save lives. (Financial Times Article, https://www.ft.com/content/36096064-e48e-11e6-9645-c9357a75844a?mhq5j=e5)
The lack of airborne medics is costing lives. Given the prestigious, varied and often rewarding nature of the work, there is a surprising global shortage of airborne medical crew. Air Ambulance operators face the HR challenge of finding doctors, nurses, paramedics and healthcare providers to meet diverse care requirements and to then globally position these aeromedical personnel. Freelance Aircrew aim to change this unacceptable status quo. We want to bring doctors, nurses, paramedics and healthcare providers to the front-line of this rewarding and challenging work. Through a relatively short and straightforward conversion (as short as a few hours with instructional video and aircraft cabin familiarisation), you can help ease the global shortage of aeromedical crews and improve the level of healthcare provided worldwide.
Sign up for free: If you are a doctor, nurse, paramedic or healthcare professional, and you enjoy working in a rewarding and often exciting sector whilst travelling globally, then sign up with Freelance Aircrew and exchange your down-time for some paid up-time.