The future of the air medical services workforce
Friday, September 20, 2013
Air medical services are an integrated element in the emergency medical system. The practice of using aviation to transport trauma patients began with the military, but today helicopters and fixed-wing aircraft can be the best — or sometimes the only — transportation available to patients in rural areas.
Changes in the healthcare industry have brought growth to clinical aviation and to the EMS workforce as a whole, as seen in the conversion of some rural hospitals to critical access status. Although the future of EMS is a complex issue, the workforce will grow into a strong, national body.
Air Ambulance Pilot
The exact makeup of an EMS flight crew depends greatly on the jurisdiction and service designation. One thing they all have in common is the air ambulance pilot. This is the most consistent element for every air mission.
The individual flying an air ambulance is usually an experienced aviator. These pilots go through an accreditation process conducted by a nonprofit agency that works internationally, but the position requires no medical training. The Bureau of Labor and Statistics estimates this industry will add approximately 11,500 jobs by the year 2020. That is an increase of 11 percent. In some rural areas, this would be an on-call position meaning the pilots work per diem.
For most EMS situations, the physician orders come via radio. As the technology advances to include more telemedicine, this role will continue to shrink outside of the military. Doctors who are part of an emergency response or a critical care team would work on-call and be available only in extreme circumstances.
A much more practical and common member of an EMS flight crew, the job outlook for a flight nurse is promising. A flight nurse is a niche job, however, and the competition will be stiff, especially in densely populated areas where the position is full-time and not on-call. Nursing is a career choice that will always be in demand whether working in a hospital or flying as part of an air medical team.
The EMT is the backbone of the EMS system on ground or in the air. BLS predicts this field will grow at a fast rate over the next decade. The average person on the street sees air medical services as the helicopters that land to remove car crash victims, but the truth is air service is expanding beyond EMS.
In the last decade, only 33 percent of air ambulance calls fit the aforementioned situation. Fifty-four percent of air missions were utilized to move critical patients from hospital to hospital, with another 13 percent credited to organ procurement and specialty services such as neonatal care. Cardiac intervention and the prevention of injuries with hyperthermia treatment is a growing consideration, as well. It is generally believed the advanced treatment window for sudden cardiac arrest is two hours or less to prevent reperfusion injury.
Air transportation from facility to facility will become more critical as the technology improves. This is where the air service paramedic or EMT-basic will find the most growth. Flight EMTs have a different patient model than the average ground paramedic. They often work with individuals that have already seen some level of care. As more facilities develop niches like trauma centers or heart hospitals, they will look to air medical services to take patients to a facility able to give them specialized treatment.
Helicopter and fixed-wing aircraft promise to play an exciting role in the future of EMS medicine. This will further cultivate the need for qualified and specially trained air medical personnel. From emergency preparedness to time-sensitive care issues, AMS will remain the most practical approach for rapid response and is a quickly growing medical field.
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