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May 22, 2019

Why is Air Ambulance Transport Helpful to TBI (traumatic brain injury) Patients?

BY Angel MedFlight

After sustaining a traumatic brain injury (TBI), many patients require a medical flight transport to travel to another healthcare facility or rehabilitation hospital. Utilizing an air ambulance for transport provides the high level of clinical care and quality needed to support such a transport. Our flight paramedic, CJ Campbell, NRP, F-PC, outlines the importance of transporting TBI patients on an air ambulance.

Why is air ambulance transport helpful to TBI (traumatic brain injury) patients?

A Traumatic Brain Injury (TBI) according to the Centers for Disease Control and Prevention (CDC) is defined as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. Anyone can experience a TBI.

Patients experiencing a TBI require specialized and comprehensive care focused on rehabilitation. They require transport to a medical center of excellence that specializes in brain injury/rehabilitation to ensure their best opportunity for recovery. These centers of excellence are scattered across the country and are not always within driving distance or the patient is unable to tolerate long ground times. It is in these instances that air transport is an appropriate solution for the patient and the family. Air ambulance provides a controlled environment with specially trained critical care teams that are available to transport patients safely, and quickly to distant locations where they receive the care they so desperately need.

What types of care are provided on a transport for a patient with TBI?

The care provided on a flight is based on the individual patient’s unique plan of care. TBI patients require different levels of care dependent on their present state of health, but with all patients the primary goal in the management of TBI is prevention of a secondary brain injury. (Examples include: seizures, high blood pressure, low blood pressure, glucose and electrolyte abnormalities, and hydrocephalus). Use of specially trained medical teams in an environment that provides safe and effective critical care to the patient is imperative. Air ambulance travel is designed to provide the patient with medical interventions to prevent further injury, and promote healing. Some patients require advanced airway management and ventilator support, many require blood pressure management, fluid management, temperature control, and therapies to reduce noxious stimulation such as excessive movement, vomiting, and noise reduction.

What is the importance of a pressurized cabin?

A pressurized cabin is important in the transport of patients who suffered a TBI especially with penetrating injuries. These types of injuries often have air pockets within the brain vault or experience swelling that may require controlled cabin pressures as low as sea level. Rotor travel cannot provide control of cabin pressures. It is important that this option is available in these situations because additional brain swelling can occur which is detrimental and can result in further damage to an already injured brain. Aircraft have the capability of maintaining a pressurized cabin that allows the patient to safely transport and that reduces dramatic changes with pressure and volume within the cranium to avoid any further injury.

Why a complex patient with TBI cannot travel by commercial airlines?

TBI patients’ responses to stimuli can be very unpredictable. These patients are very sensitive to sound, vibration, and changes in pressure Complex treatment modalities and specially trained medical personnel are paramount to ensure a safe transfer from bedside to bedside. Individuals with TBI are under significant stress and adding transport of any kind may be overwhelming. When the complexed patient is stressed their safety and health may be at risk. Traveling via medical air ambulance with a trained medical team and limited stimulation of other unknown stressors, provides the safest form of transport, as treatment is readily available if the patient reacts negatively to what can be a very overwhelming dynamic environment.

Learn more about the clinical training for air ambulance.

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