When:
- Patient requires an RN / Paramedic Critical Care team and/or specialized equipment
- A decreased out-of-hospital time is necessary to optimize patient outcome
- The patient’s condition requires critical care life support (monitoring, personnel, medications or specific equipment) not otherwise available
- Patient requires rapid access to a tertiary and definitive care facility
- The potential for delays in transport (traffic, distance) may be associated with worsened patient outcome
- The use of a local ground transport team would leave the local area without adequate EMS coverage
Trauma:
- Multiple system injury
- Spinal cord injury or major vertebral injury
- Acute Paralysis
- Intracranial bleeds
- Chest wall injury with known or possible development of respiratory/cardiac issues
- Patient who require prolonged ventilation
- Unstable pelvis or other unstable fractures that could be worsened by ground transport
- Fractures/dislocations with the loss of distal pulses
- Altered mental status secondary to trauma related incident
- Near-drownings with respiratory or potential respiratory issues
Medical:
- Respiratory failure or distress
- Mechanical ventilation required
- Sepsis
- Single or multiple organ system failure
- Cardiogenic shock
- Cardiac arrhythmias
- AMI requiring rapid transport
- Aortic dissection
- Stroke – with or without thrombolytic administration
- Conditions requiring blood transfusion enroute
- Overdose with an altered level of consciousness
- Uncontrolled seizure activity
- Patient’s requiring hyperbaric treatment
- High risk obstetric patients (birth must not be imminent)
- Meningitis
- Acute renal failure
- Hyperthermia/hypothermia
- Patient’s requiring titrated vasoactive medications to maintain blood pressure
- Anaphylaxis
- Environmental emergencies (hypothermia, hyperthermia)