Medical evacuation does not involve emotions

Nov 04, 2023

The sanitary evacuation market in Russia is very specific and diverse. Understanding all the nuances and specifics, as well as not falling for the bait of incompetent companies, is a very difficult task, but quite solvable. The main thing for relatives whose loved ones are in trouble should be a strong mind and no haste. You need to carefully approach the choice of a company that will help you safely and quickly transport a patient, as well as select medical support, preferably relying on the experience of friends and acquaintances.

Today, Maxim Manaenkov, director of business development for the Russian broker in the air ambulance market JETVIP , is visiting BizavNews, and we are starting a series of materials about medical evacuation in Russia.

First of all, you need to understand that if your loved ones are in trouble, you must control your emotions. If possible, immediately contact specialists who will take care of all organizational issues. “We are actively working with the Federal Center for Disaster Medicine of the Ministry of Health of the Russian Federation. But here you need to understand that FCMC only includes highly qualified doctors and medical equipment.

We often turn to them on a commercial basis, or transport a patient as part of a government assignment. A very small number of people know that if, God forbid, you have a relative or any close person in trouble in Russia, and he needs urgent transportation, but let’s say he is not transportable on a regular flight due to medical reasons or technical features of the route, then In this case, the Government of the Russian Federation has a specially allocated Federal or Regional budget for evacuation, and absolutely any citizen of Russia, regardless of social status, can be transported completely free of charge to provide emergency medical care, for example, to a regional center, if within a radius of 500 km. there is no proper medical equipment or medical facility - everyone can receive free medical evacuation, the cost of which can vary from 2 million to 25-30 million, of course, if all the criteria are met and it is impossible to provide medical care “on the spot,” says Maxim.

Maxim does not hide the fact that he learned about this in 2017, but since then he has been trying to help each of those who applied as much as possible. “It’s very good that it works for us. Yes, it’s rough, and it’s not always as fast as we’d like, but it works. But the fact that they don’t know about it is very negative.”

It works as follows. When relatives know where to write and what to write, the appeal falls to the Ministry of Health. The Ministry of Health gives the Federal Center for Disaster Medicine the task of working on this task. Next, the specialists from           FCMC, together with the Ministry of Health, work out a variation of evacuation, look at the patient’s condition, conduct telemedicine, and check for transportability on regular airlines or on a specially equipped private plane.

Next, a medical team and a set of necessary medical equipment is formed to accompany the patient. As a rule, if this is a commercial story and the patient does not fall under the requirements of free transportation, then the average bill for the team’s work varies from 130,000 to 250,000. These are resuscitation doctors and a paramedic (nurse/nurse) and all the necessary medical equipment, regardless of the patient’s condition, On the plus side, if we are talking about regular transportation, tickets for doctors, patients, accompanying relatives are purchased, a medical module is installed (each airline has its own tariffs for it) and the tariff for excess baggage is paid. If we are talking about a private plane, then in a short time, the plane takes 3-4 hours to prepare from the moment of confirmation, doctors arrive at the airport 30-40 minutes before departure and fly out to pick up the patient.

At the moment when the decision is made about the transportability of the patient and the aircraft is selected, the work of JETVIP begins. “I am given a very specific task. For example, fly to Ulan-Ude, pick up the child there and bring him to Moscow. I find out the diagnosis and condition of the patient. By simple experience, I already know what questions to ask them right away, although they usually send me answers later, even if I don’t ask. From this, we, together with the doctors, understand which plane is suitable. This may not be an equipped aircraft, because in fact there is no such thing as a “special aircraft”; it is not fixed in any way. That is, there is simply an airplane that conditionally has a medical module, but a patient in serious condition can be transferred even on a sofa, where a medical shield (stretcher) is pre-installed and a vacuum mattress is placed, and then this is not always necessary, the main thing is that during takeoff and the patient’s position could be secured with transverse seat belts.”

As for regular airlines, they are not always willing to take patients on board, citing internal safety rules, but most often they simply refuse without justification. But for without

dangerous transportation of a patient, you just need to buy 6-8 seats and install a certified medical module on it, which is available in almost every major airline, and all the medical equipment of FCMC doctors is certified for air transportation in the aircraft cabin, including lithium-ion batteries for ventilation and other autonomous equipment or oxygen cylinders.

Basically, the function of the medical module is simply to provide a comfortable and rigid surface for the patient to sit on. The patient is accordingly secured with transverse straps in accordance with the Federal Aviation Regulations. And everything seems to be fine, but no - carriers often refuse transportation, although from a commercial point of view they do not lose a penny, but the truth is that the risk of a forced landing increases and in this case the airline may incur additional costs.

It's much easier with private boards. However, the flight arranging specialist must have as much information as possible about the patient, including his height and weight. Very often these facts are ignored and as a result, when the patient is brought to the airport, he simply cannot be brought on board. The reason for this is that the technical characteristics of the plane are not taken into account, and the patient simply does not fit into the emergency exit, since on many planes the patient is carried in through it, but on some, for example, through a narrow passage in the rear of the plane, where it is easy to carry a large person not safe. All factors must be taken into account.

“For example, a person has a very serious traumatic brain injury, he is in a coma, he needs to be carried very gently, without tugging or shaking. And this was the first and last time I flew on a Yak-40 with such patients, because this plane is not suitable for carrying a patient: there is a narrow ladder in the rear, the patient lies on a medical board on a stretcher, by the sides of his legs and head Doctors are holding it, they have equipment on the side, and people are also holding it on this side. If it’s heavy, how can we bring it in? At that moment I was worried about him as if for my relative, but in the future I would rather refuse or offer a larger plane, but, unfortunately, the choice is not so great and there is not always availability for the required plane. In general, many factors need to be taken into account,” continues Maxim.

A medical evacuation specialist must always be prepared for any development of the situation. You need to have a good understanding of the medical aspects and specifics of evacuation from different countries. “Some time ago, we, together with a Turkish airline, transported a patient, the relatives themselves transported the patient to Russia, and we had to carry the patient further across Russia. After the Turkish doctors, the FCMC doctors remained extremely dissatisfied with the patient’s condition, and this is not the first time this situation has happened, and not only with me, because they took a normal patient from the hospital, handed him over to the Turks, who was also normal, brought him to us in Russia and handed over the patient as if he was different, and The doctors were dressed simply in civilian clothes, without personal protective equipment. Yes, the price tag for a Turkish flight is noticeably cheaper, but I always try to explain to my relatives all the nuances and most often my arguments are accepted, in some cases it is better to fly on regular airlines than on a private plane, even when the cost is not an issue, because life and health always come first patient. This is especially true for those patients who are transported in serious condition; it is better to listen to a specialist rather than try to find the fastest or cheapest option. Do you know how many times they started communicating with me with the phrase “I need to fly out as soon as possible, I need to fly today,” and as a result, the evacuation took place, for example, in a week, because my relatives did not listen to me and took a million pieces of advice from everyone except me, although they couldn’t fly out later means wasting precious time.

And one more piece of advice: relatives do not need to accompany the patient. “In 9 cases out of 10, I am against relatives flying as accompanying persons. Imagine a picture of a seriously ill patient – a medical team and relatives giving 500 pieces of advice, whose mother’s friend’s son is a doctor, who is also on the phone and everyone around is telling them how the FCMC doctors should do their job correctly. I believe that it is normal to fly with an accompanying relative only if a child is flying, since they are his legal representatives, or when the plane has a second cabin where accompanying people can fly, but in fact there are no such planes in Russia. When the plane is small, there are only 5 seats and a 3-seater sofa where the patient is placed, medical equipment is located on 2 chairs, doctors are on 2 more chairs, and there remains 1 more chair, to which the doctor’s chair is most often moved so that it is impossible to sit there. This, of course, is not every time and when it is possible to take an accompanying person, we will always take it, but if not, then I tactfully convey the reason for the refusal or explain that the doctors do not need to be touched and that they are professionals in their field, but the situations were different.”

Not long ago, the Ministry of Health of the Republic of Ingushetia

, in particular I.O. Minister Antoshkieva Zarema Akhmetovna and Deputy Minister Ugurchieva Khyadi Yusupovna completed the task so lightning quickly and truly professionally that many regions should learn from them and when they asked that her sister fly with the patient, it was simply inhumane to refuse, since at each stage During the evacuation, we worked as one team and in this situation, a relative on board could not have a negative impact on the evacuation.

To be continued….

JETVIP is the No. 1 company in business aviation in the Russian Federation.

Author of the article: Maxim Manaenkov

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