Guidelines for Utilization

“ON-SCENE” RESPONSES: Mercy Flight should be used when the helicopter will significantly reduce the transport time to a trauma or specialty care center. It should also be used if the specialized services offered by the Mercy Flight medical team would benefit the patient prior to arrival at the hospital. Some of the parameters that may be considered include:

v Vital Signs / Level of Consciousness

Ø Loss of consciousness at any time >5 minutes or alteration in level of consciousness at time of exam or thereafter (GCS<13)

Ø Respiratory rate <10 or >28, Pulse rate <50 or >120, Systolic BP <90

Ø Rates outside the normal ranges for pediatric patients

v Injuries

Ø Penetrating injuries to the chest, abdomen, head, neck or groin

Ø Two or more proximal long bone fractures or an open fracture of one long bone

Ø Flail chest

Ø Degloving injury or major amputation

Ø Combined system trauma involving two or more body systems

Ø Suspected pelvic fractures

Ø Open or depressed skull fracture

Ø Suspected spinal cord injury or limb paralysis

Ø Critical burnsv Mechanism of Injury

Ø Falls of 20 feet or more for adults, 10 feet or more for patients 12 years of age or younger

Ø Prolonged extrication time exceeding 30 minutes

Ø Rollover, ejection of the patient or death of occupant in the same car

Ø Pedestrian struck by a vehicle travelling 20 miles per hour or greater

Ø High speed crash with intrusion into the passenger compartment of more than 12 inches

v Critical Medical Conditions

Ø Suspected acute stroke with positive Cincinnati pre-hospital stroke scale when patient’s expected arrival at a Stroke Center would be within 2 hours of symptom onset.

Ø Suspected acute myocardial infarction with EKG findings or ST elevation 1mm in 2 or more contiguous leads or LBBB (QRS duration greater than .12msec and Q wave in V1 or V2)

INTERFACILITY TRANSFERS: Physicians may request that a patient be transferred between medical facilities by helicopter in order to minimize “out of hospital” time or when the appropriate level of care cannot be provided by ground ambulance. Some of these scenarios are described below:

v Critical Care Advanced Life Support exceeds routine use of cardiac monitor, oxygen and IV fluid maintenance or a specialty-care environment is required that cannot be provided by ground ambulance.

v Patient’s condition requires transfer to an institution with a higher level of care and air-medical transport would significantly reduce the “out of hospital” and transport time.

v Patient is returning to a community hospital after stabilization and requires Advanced Life Support or specialty care during transport. Some examples of patients who would be transferred by helicopter include:

v Patient needs emergent cardiac catheterization

v Patient needs to be seen at a tertiary care center for advanced care and out of hospital time needs to be minimized

v Patient is an adult requiring Advanced Life Support with a history of unstable vital signs (Systolic blood pressure <90, Respiratory rate <10 or >35, Heart rate <50 or >130.)

v Patient is a high-risk mother requiring transfer to a regional perinatal center

v Patient is a high-risk infant requiring the expertise of the regional neonatal transport teamv Patient is an infant or child requiring Pediatric Advanced Life Support with a history of unstable vital signs.

Mercy Flight

Guidelines for Utilization

INTERFACILITY TRANSFERS: Physicians may request that a patient be transferred between medical facilities by helicopter in order to minimize “out of hospital” time or when the appropriate level of care cannot be provided by ground ambulance. Some of these scenarios are described below:

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