SPECIAL NEEDS

CANCER PATIENT TRANSPORTATION

Cancer is a leading cause of death worldwide, accounting for more than 10 million deaths per year, or one in six deaths. Cancer continues to be the second most common cause of death after heart disease.

Cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries. They can then invade adjoining parts of the body and spread to other organs; the latter is metastasis or stage IV cancer. Widespread metastases are the primary cause of death from cancer. There are more than 120 different types of cancer. The deadliest cancers are lung and bronchial, colorectal, breast, pancreatic, prostate, leukemia, non-Hodgkin’s lymphoma, liver, intrahepatic bile duct, ovarian, esophageal, and brain cancer.

A suppressed immune system is one of cancer’s many potential side effects and treatments. Immunosuppression reduces the body’s ability to fight infection and disease. Following the recommendation of the sending or receiving physicians, arranging medical transport with strict infection control measures is essential to prevent unnecessary exposure for the patient.

Cancer patients needing transport over long distances are generally transported by fixed-wing air ambulance when other means of transportation like ground ambulance or helicopter are unpractical or contraindicated. 

Some of the best Cancer Centers for adults in the US are:

  1. The University of Texas MD Anderson Cancer Center, Houston, TX
  2. Memorial Sloan Kettering Cancer Center, New York, NY
  3. Mayo Clinic, Rochester, MN
  4. Dana-Farber/Brigham and Women’s Cancer Center, Boston, MA
  5. Cleveland Clinic, Cleveland, OH
  6. Johns Hopkins Hospital, Baltimore, MD
  7. Northwestern Memorial Hospital, Chicago, IL
  8. UCLA Medical Center, Los Angeles, CA
  9. Cedars-Sinai Medical Center, Los Angeles, CA
  10. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia, PA
  11. UCSF Health-UCSF Medical Center, San Francisco, CA
  12. Stanford Health Care-Stanford Hospital, Stanford, CA

Some of the best Pediatric Cancer Centers in the US are:

  1. Children’s Hospital of Philadelphia, Philadelphia, PA
  2. Dana-Farber Cancer Institute, Boston, MA
  3. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
  4. Texas Children’s Hospital, Houston, TX
  5. Children’s National Hospital, Washington, DC
  6. Children’s Healthcare of Atlanta, Atlanta, GA
  7. Children’s Hospital Los Angeles, Los Angeles, CA
  8. Nationwide Children’s Hospital, Columbus, OH
  9. Children’s Hospital Colorado, Aurora, CO
  10. St. Jude Children’s Research Hospital, Memphis, TN
  11. Seattle Children’s Hospital, Seattle, WA
  12. Johns Hopkins Children’s Center, Baltimore, MD
  13. MSK. Kids at Memorial Sloan Kettering Cancer Center, New York, NY

Cancer patients are most of the time transported to receive a diagnosis, treatment, and oncology care at a specialist Cancer Center, or when treatment has concluded, to return home, home health, hospice care, or to a skilled nursing facility.

When the disease is too advanced, a cure is not likely, and the patient is diagnosed as terminal, or within the last months of life, cancer patients may be transported to hospice care to be provided with palliative care or supportive care to help alleviate the cancer symptoms and pain. Terminal patients transported out of hospital are generally discharged with an Out of Hospital DNR, which is a legal form that tells EMS professionals to start or not specific life-saving procedures to respect the wishes of the patient or his next of kin.

At Air Medical Transport, we understand how hard it can be for patients and family members after receiving life-changing news to choose an air ambulance service to adequately transport their loved one to or from a specialized cancer center. 

At Air Medical Transport, we are always eager to assist all our clients to get the best air medical transportation solutions they need. Call one of our flight coordinators anytime to program ahead for any air medical transportation case.

PATIENT TRANSPORT WITH SPECIALIZED SYNDROMES

GENETIC AND RARE DISEASES

There are more than 1,200 rare diseases globally. Patients with rare diseases present unique challenges for medical providers and transportation. Obstacles to caring for these patients include diagnostic delays and a lack of information, expertise, and treatment options for many rare diseases. Most of the time, this type of patient needs the individual diagnoses, treatment, and care of specialty medical centers and physicians highly specialized in the unique, rare disease.

When the patient’s transport is necessary and is unpractical or contraindicated by other means, Air Medical Transport can quote, assist, and arrange the air medical service needed domestically or internationally.

LOCKED-IN SYNDROME

Locked-in syndrome is a rare neurological disorder caused by damage to the pons, a part of the brainstem containing nerve fibers that relay information to other brain areas.

Patients with Locked-in syndrome have complete paralysis of all voluntary muscles except for those that control the eyes’ movements. They are conscious and awake but cannot produce movements (outside of eye movement) or speak (aphonia). Their cognitive function is generally unaffected. Patients can only communicate through eye movements or blinking.

A careful fit-to-fly evaluation based on the patient´s current needs and hemodynamic stability help minimize risks and possible complications during bedside-to-bedside transport.

EHLERS DANLOS SYNDROME PATIENT TRANSPORT

Ehlers-Danlos syndrome (EDS) is a group of inherited disorders that weaken connective tissue caused by contrasting genetic defects in collagen. Collagen is one of the crucial structural components of our body. Collagen is a tough fibrous protein that is an essential building block in providing flexibility (e.g., cartilage) and strengthening connective tissue (e.g., bones).

The main complications seen in EDS involve the skin, muscles, skeleton, and blood vessels. Patients with EDS often have skin described as “velvety” or “loose”. This skin characteristic predisposes patients to wound healing problems. Patients will often develop “paper-thin” scars. Patients also have excessively flexible, loose hypermobile joints that are easily and frequently dislocated. Eventually, fragile blood vessels leave patients experiencing easy bruising and even an increased tendency to severe bleeding episodes.

Surgery is sometimes recommended for many reasons for EDS patients. Depending on the type of EDS and severity, there could be an increased risk of various surgical complications such as excessive bleeding, wound healing problems, dissection, and hernias. Surgery for non-life-threatening conditions particularly should be carefully considered. Propper pre-transport evaluation is of crucial importance.

TYPES OF EHLERS DANLOS SYNDROMES:

  • Cardiac-valvular type (cvEDS) is a rare subtype of EDS in which patients may have minor signs of EDS with severe defects to their aorta, requiring surgical interventions.
  • Vascular type (vEDS) can be identified at birth with noticeable clubfoot deformities and dislocation of the hips.
  • Hypermobility type (hEDS) comes with a defined set of complications to be managed. However, it is generally a less severe form of the syndrome.
  • Arthrochalasia type (aEDS) is associated with the lifelong risk of dislocating multiple major joints concurrently.
  • Dermatosparaxis type (dEDS) A significant complication of dEDS is herniation, the improper displacement of an organ through the tissues holding it in a proper position.
  • Kyphoscoliotic type (kEDS) is accompanied by scleral fragility, increasing the risk for rupture of the white globe of the eye.
  • Brittle cornea syndrome (BCS) is a variant of EDS involving the eyes. Patients with variant risk ruptures to the cornea following minor injuries with degeneration, scarring, and protrusion.
  • Spondylodysplastic type (spEDS) variant with skeletal dysmorphology. It mainly involves the spine and the hands.
  • Musculocontractural type (mcEDS) is characterized by progressive multisystem complications. This subtype is mainly associated with developmental delay and muscular weakness plus hypotonia.
  • Myopathic type (mEDS) is characterized by muscle hypotonia evident at birth with muscles that do not function properly.
  • Periodontal type (pEDS) has findings that include disease of the tissues supporting and surrounding the teeth (periodontal disease), potentially resulting in premature tooth loss.

The treatment and management of (EDS) Ehlers-Danlos syndrome focus on preventing serious complications and relieving signs and symptoms. Management strategies differ slightly pending on the specifically mentioned subtypes. Different medical specialists may need to be involved because several body systems may be affected. For transport, the leading management aspects include cardiovascular workup, respiratory therapy, pain management, and relief of signs and symptoms.

GUILLAIN-BARRE SYNDROME PATIENT TRANSPORT

Guillain-Barré syndrome (GBS) is a rare syndrome that can occur at any age. However, it is prevalent in people older than 50-years-old. The patient’s body’s immune system attacks part of his peripheral nervous system. Guillain-Barré syndrome causes are unknown. In many cases, GBS occurs a few days or weeks after symptoms of a viral infection. In rare circumstances, GBS may run in families. The peripheral nervous system carries the signals from the brain to the muscles.

Signs and symptoms of Guillain-Barré syndrome (GBS) include muscle pain, muscle weakness, numbness, and tingling sensations, which can increase in intensity until (paralysis) the muscles cannot be used.

GBS can affect people of any age. The first symptoms of GBS typically begin in the lower legs. The symptoms can then spread to the muscles of the upper body. Typically, the symptoms continue to worsen over the first 2-to 3 weeks after they start. In some cases, the symptoms of GBS can increase in intensity until (paralysis) the muscles cannot be used at all.

Other symptoms of GBS can include difficulty with bowel function or bladder control, difficulty breathing, altered blood pressure and heart rate. Some people with GBS have facial droop, difficulty speaking or swallowing, double vision, and changes in eye movements. As the disease progresses, the muscle weakness may worsen, affecting the essential muscles for breathing.

People with GBS may be admitted to the hospital for treatment and reduce the risk of complications. In some cases, other treatments may be necessary to prevent complications, including heparin and pain medications to reduce the risk of blood clots. Patients with GBS may require help breathing with a ventilator.

PATIENT TRANSPORT FOR REHABILITATION

SPINAL CORD INJURY

Every year approximately 500,000 people suffer a Spinal Cord Injury (SCI). Most spinal cord injuries are due to preventable causes such as motor vehicle accidents, falls, or violence. Patients with a spinal cord injury are two to five times more likely to die prematurely than patients without a spinal cord injury, with worse survival rates in low- and middle-income countries.

In the United States, there are approximately close to 300,000 Americans living with SCI and about 18,000 new SCI cases each year, with close to 78% of them male patients.

A spinal cord injury is a damage to the tight bundle of cells and nerves that sends and receives signals between the brain and the rest of the body. SCI can be caused by direct injury to the spinal cord or damage to the tissue and bones (vertebrae) that surround the spinal cord.

Depending on the body functions below the injury site, rehabilitative care may include breathing assistance using a transport ventilator that produces forced air, treating any respiratory or circulatory problems, pain medications, and learning new ways to address bladder and bowel problems.

BRAIN INJURY

Traumatic Brain Injury (TBI) affects over 60 million people annually in the world, leading to either hospitalization or mortality. Every nine seconds, a person in the US sustains a brain injury, culminating in more than 3.5 million injuries each year. Falls are the primary cause of brain injury resulting in 40.5% of all TBIs. There are several clinical classifications for brain injuries.

Men are twice more likely to suffer a TBI and are at much higher risk. Doctors refer to injuries that do not occur at or around the time of birth and are not genetic or degenerative as an Acquired Brain Injury (ABI). An ABI can be either a nontraumatic or a traumatic brain injury, depending on the injury’s inciting source.

Non-traumatic brain injuries include infectious disease, electric shock, toxic exposure, metabolic disorders, neurotoxic poisoning, lack of oxygen, drug overdose.

Traumatic Brain Injuries (TBI) include car and motorcycle accidents, sports injuries, abusive head trauma, gunshot wounds, workplace injuries.

Some of the best hospitals for rehabilitation in the US are:

  1. Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL
  2. TIRR Memorial Hermann, Houston, TX
  3. Spaulding Rehabilitation Hospital, Charlestown, MA
  4. Kessler Institute for Rehabilitation, West Orange, NJ
  5. UW Medicine-University of Washington Medical Center, Seattle, WA
  6. Mayo Clinic, Rochester, MN
  7. Shepherd Center, Atlanta, GA
  8. Rusk Rehabilitation at NYU Langone Hospitals, New York, NY
  9. MossRehab, Elkins Park, PA
  10. Craig Hospital, Englewood, CO
  11. UPMC Mercy, Pittsburgh, PA
  12. New York-Presbyterian Hospital-Columbia and Cornell, New York, NY
  13. Baylor Scott and White Institute for Rehabilitation-Dallas, Dallas, TX
  14. Mount Sinai Hospital, New York, NY
  15. Carolinas Rehabilitation, Charlotte, NC
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