Critical care at 30,000ft

Paul Ingram 30 Apr 2024

Transporting a Critical Care patient within a hospital is sometimes a difficult and dangerous task. At 30,000ft transporting a Critical Care patient from hospital to hospital or accident scene to a hospital can be even more difficult and dangerous when combined with the aviation environment.

Discussion

The Royal Flying Doctor Service (RFDS) Western Operations transfers over 9,000 patients per year with approximately 50% requiring the expert care of a dedicated RFDS Critical Care Retrieval Team. The team comprises an RFDS Retrieval Doctor and an RFDS Flight Nurse only, and of course the pilot.

At 30,000 ft there is no access to any additional personnel or equipment. No pathology, no x-ray, no CT scanner and no theatre to call upon for help.

Combine this isolation with the confined space of an aircraft cabin and you have an “ICU in a telephone box”.

Add in the aviation environment and the associated gas laws related to the temperature, pressure, volume and mass of a gas and you have a “Flying ICU in a telephone box”.

Conclusion

To successfully transport a Critical Care patient safely at 30,000 ft a significant amount of patient preparation and stabilisation is required prior to commencing the transport.
Combine this with the broad experience and excellent clinical skills of the RFDS Critical Care Retrieval Team and this is why the RFDS continue to provide the finest care to the furthest corners of Australia and even beyond.

References

1. Holleran RS. Air & Surface Patient Transport: Principles and Practices. 3rd Edition. Mosby 2003.
2. Holleran RS. Emergency and Flight Nursing Review. 2nd Edition. Mosby 1996.
3. Langford SA. Preparation of Patients for Transport. Royal Flying Doctor Service of Australia. Monograph Series Number Two. 2009.
4. Holleran RS. Flight Nursing: Principles and Practices. 2nd Edition. Mosby 1996.

Paul Ingram

Head of Nursing - Royal Flying Doctor Service, Western Australia

Paul Ingram joined the Royal Flying Doctor Service way back in May 1998 when he was still a ‘boy’ as a Flight Nurse at our Meekatharra Base.

Paul spent 16 months in Meekatharra honing his Flight Nursing skills and acclimatising to the red dirt before relocating to our Jandakot Base as a Flight Nurse in November 2000.

Originally from Victoria Paul headed to Derby in July 1997 for a 2 year ‘sea change’ working at the local hospital where he saw first hand the work of the RFDS which raised his interest in joining. Paul had 12 years nursing experience behind him in Regional Victoria with his hometown being Ballarat. Included in those 12 years were two post graduate courses, one in Midwifery and another in Paediatrics at the Royal Children’s Hospital in Melbourne.

Paul’s hard work ethic, people focus and passion for Nursing has seen him steadily climbed the Nursing ranks within RFDS holding previous positions as Senior Flight Nurse, Flight Nurse Coordinator, Clinical Nurse Manager and Deputy General Manager of Nursing.

Paul will begin the Leadership WA Signature Program in 2020.