Training

Training consists of three elements.

1. Professionals involved in transporting critically ill patients should have a knowledge base of training relevant to the disease states of the individual being transported. The patient may be injured or may have a cardiac history, and so the transport personnel must be trained in many disciplines.

2. The second element is formal training, which includes the principles listed in TableJ.. The Royal College of Nursing of the United Kingdom has developed an in-flight nursing course, and more recently the British Trauma Society has recommended a syllabus for training individuals involved in intrahospital transport.

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3. The third element includes education in transport medicine, which involves altitude medicine. Familiarity with different transport vehicles is necessary for those involved in aeromedical transport training. Personnel are supervised prior to being independently incorporated into the transport team.

Educational models consist of a mixture of didactic, clinical, and procedural experiences. Procedural education includes ensuring that a flight team is familiar with indications, with the techniques for every procedure utilized in the aeromedical environment, and with complications. The flight team's knowledge, judgment, and performance can be evaluated by written test, oral examination, and field observation. The process of quality assurance and continuous quality improvement may help to maintain standards and improve patient care.

Initial flight crew training should include flight physiology and discussion of the various concepts of the pressure, volume, and temperature relationships of gases, including Boyle's, Henry's and Charles' laws. The composition, pressure, and temperature profiles of the earth's atmosphere and the physical and physiological effects of noise, vibration, and acceleration must be discussed. The principles of emergency medical services and mass casualty response, as well as search, rescue, and survival techniques, are also part of the curriculum. The crew should be familiar with hazardous materials and what to do when involved with them. Patient care training should include the disorders of neurological disease, respiratory disease, cardiovascular disease, trauma, high-risk obstetric and neonatal disease, and pediatric disease. The transport personnel should be familiar with aviation and aircraft safety and with equipment such as the battery master switch and fuel shut-off valve on helicopters, as well as the medical equipment which includes monitors, oximeters, mobilization equipment, and defibrillators. Infection control procedures should be included as part of the education.

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