Choosing an air ambulance
People are used to looking for air transportation based on price, just as they may do for personal travel. But air medical travel involves more than transportation. It is also a health care service operating under difficult and often changing circumstances. Also, there is little government or other regulatory oversight of the air ambulance industry. It is very important to ask questions before you make a decision. Mayo Clinic Ambulance Service staff is available to help answer any questions.
Questions to ask
What is the company's safety record? Has it had any Federal Aviation Administration (FAA) violations?
- Industry standards: Industry standards do not exist for air ambulance services. Most companies have outstanding safety records.
- Mayo Clinic standards: You can be assured of the safety of Mayo Clinic's air ambulance transports because of the annual safety audits and strict internal quality, safety standards and accreditation by the Commission on Accreditation of Medical Transport Systems (CAMTS).
What type of aircraft will be used? Does it have the capability to fly in all weather? Is the cabin pressurized? What guarantee is there that the plane indicated will actually be the one used?
- Industry standards: A variety of aircraft are used throughout the industry, from very small, nonpressurized aircraft to larger planes.
- Mayo Clinic standards: Mayo Clinic uses only pressurized, all-weather aircraft dedicated to medical transport. The aircraft cabin is ideally suited for medical transportation and is not used part time for charter flights or ferrying freight. Medical equipment is routinely checked by qualified medical staff working in cabin interiors of sufficient size to ensure patient comfort and quality care. Pressurized aircraft can fly above cloud level, ensuring a smooth ride in most weather conditions. In nearly all cases, Mayo Clinic's medical airplane has room available for a family member or guardian to travel along at no additional charge.
What are the pilot qualifications?
- Industry standards: Minimal federal regulations allow some aircraft to be operated by a single pilot with a minimum of 1,500 hours' total flying time as pilot in command.
- Mayo Clinic standards: Mayo Clinic requires two pilots for each airplane flight. Our pilots are full-time team members dedicated to emergency medical services and do not fly other missions. All Mayo Clinic's medical airplane pilots hold an Airline Transport Pilot Certificate, the highest certification available.
Is the air ambulance company a member of the Commission on Accreditation of Medical Transport Systems (CAMTS)? Is it CAMTS accredited?
- Industry standards: CAMTS membership varies throughout the industry. In the absence of state and federal regulations, membership in CAMTS can ensure that minimum safety and competency standards are being met.
- Mayo Clinic standards: Mayo Clinic's medical airplane team is accredited by CAMTS. To attain accreditation, the service is evaluated on safety standards, education, equipment, staffing, communications, maintenance and administration.
What are the transport team qualifications? Has the team had any special training?
- Industry standards: There are no federal requirements regarding the medical qualifications of flight teams.
- Mayo Clinic standards: All Mayo Clinic Ambulance Service air ambulance transport nurses, paramedics, respiratory therapists and other specialists work at Mayo Clinic and are experienced in critical care medicine. Transport nurses and paramedics are trained in Advanced Cardiovascular Life Support. Specialized teams are available for both pediatric and neonatal care, and all team members are trained in flight physiology and have annual safety training. Each flight team is selected based on the patient's unique current and potential needs, which is also the case for the selection of all equipment — from automated external defibrillators to neonatal transporters. Flight team members are also dedicated medical transport professionals, rather than individuals pulled from other medical units when needed for a flight.
Is there a medical director?
- Industry standards: No federal laws require air ambulance companies to employ a medical director. A doctor may or may not be involved in the transport.
- Mayo Clinic standards: Our medical director is a Mayo Clinic doctor trained in emergency medicine. The medical director oversees all training programs and is responsible for the overall quality of the Mayo Clinic's air ambulance service. A medical director or a doctor well-versed in emergency medicine is always available for discussion and consultation when arranging a transport. All Mayo Clinic air ambulance teams follow medical guidelines and protocols developed in conjunction with a doctor. Flight team performance is also reviewed by a doctor after the flight to ensure that quality standards are met.
Will the health care team be in contact with a hospital during the transport?
- Industry standards: There are no federal requirements that a transport team remain in contact with a hospital during transport.
- Mayo Clinic standards: Mayo Clinic's air ambulance flight teams stay in close contact with emergency room doctors and other professionals at Mayo Clinic Hospital, Saint Marys Campus. A Mayo Clinic doctor can communicate with the medical transport team via two-way radio or air phone during flights in the event of a medical emergency, unexpected complication or worsening of a patient's condition during flight.
What equipment will the team carry, and will a full complement of medications, monitors and oxygen be provided?
- Industry standards: Few federal requirements specify what equipment or drugs must be carried.
- Mayo Clinic standards: Mayo Clinic's air ambulance flight teams carry a full complement of critical care medications, monitoring equipment and oxygen. The teams provide highly specialized supplies and equipment — ranging from basic supplemental oxygen to advanced medical equipment — if patients have complex medical needs. Equipment, medications and crew member training is comparable to that of a critical care unit or emergency department at a hospital. Packed red blood cells (3 units), thawed plasma (3 units), whole blood (2 units) and platelets (1 unit) are available for every flight. Mayo Clinic's air ambulances carry a portable lab analyzer that measures arterial or venous blood gases, electrolytes, hemoglobin, lactate, and international normalized levels (INR) levels.
How many health care team members attend a flight?
- Industry standards: No requirements specify how many team members must accompany a transport. Many companies provide only one health care specialist.
- Mayo Clinic standards: Mayo Clinic selects a team of at least two critical care medical professionals, chosen according to the medical needs of each patient. This ensures that there are adequate personnel on board to treat a medical emergency should the patient's condition worsen.
What is the cost? When is payment required?
- Industry standards: Medical air transport costs vary greatly, and price alone is not a quality indicator. Costs are seldom covered by insurance, and many services require full payment in advance.
- Mayo Clinic standards: We provide cost estimates in advance, during the initial call for service. We can also assist patients in filing insurance claims and obtaining any necessary pre-authorization when an insurance plan covers air ambulance service. In most cases, full payment is required at the time of service, and most often payment is not covered by insurance if the flight is not medically necessary.