Mercy Flight Central - Critical Care at Your Most Critical Hour - Emergency Medical Transport Services in New York

Utilization Criteria

The following guidelines are for circumstances and patient types that may benefit from rapid transport to a tertiary care facility with specialized personnel and equipment.

Direct transport from the accident scene to a trauma center has been shown to improve patient survival, reduce disability, shorten hospital stays and reduce costs.

GENERAL CRITERIA
Required critical care life support (monitoring, personnel, medication, or specific equipment) during interfacility transport that is not available from the local ground ambulance service.
Clinical condition required that the time spent between hospitals (out of the hospital environment) to be as short as possible.
Specific or timely treatment required is not available at the referring hospital.
Condition requires care by receiving hospital's physicians intimately familiar with the patient's history, chemotherapy, or previous extensive invasive procedures.
Use of local ground transportation would leave the local area without adequate EMS coverage.
Potential delays associated with ground transport (road obstacles and traffic) is likely to worsen clinical condition.
Area was inaccessible to regular ground traffic.
PEDIATRIC PATIENTS
Experienced or at risk for developing cardiac dysrhythmias or cardiac pump failure that
requires intervention not available at the referring hospital.
Experienced or at risk for developing acute respiratory failure or respiratory arrest and is not responsive to initial therapy.
Invasive airway procedure with assisted ventilation.
Respiratory rate < 10 or > 60 breaths per minute.
Systolic blood pressure Neonate < 60mmHg
Systolic blood pressure Infant (< 2 years) < 65mmHg
Systolic blood pressure Child 2-5 years < 70mmHg
Systolic blood pressure Child 6-12 years <80mmHg
Near-drowning with signs of hypoxia or altered mental status.
Status epilepticus
Acute bacterial meningitis
Acute renal failure
Unstable toxicological syndrome
Reye's syndrome
Hypothermia
Multiple trauma
TRAUMA PATIENTS
Lengthy extrication with severe injuries
Motor vehicle accident with structural intrusion into patient’s space in the vehicle.
Motor vehicle accident with ejection from vehicle.
Motor vehicle accident with another person in the same vehicle died.
Motor vehicle accident with patient a pedestrian struck by a vehicle traveling > 20mph
Motor vehicle accident with patient not wearing a seatbelt in a car which overturned.
Motor vehicle accident with front bumper of vehicle displaced to the rear by more than 30 inches.
Motor vehicle accident with front axle displaced to the rear.
Patient was thrown from a motorcycle traveling more than 20 mph.
Fall from a height > 20 feet.
Penetrating injury anywhere on the body between the mid-thigh and the head.
Amputation or near-amputation
Scalping or degloving injury
Severe hemorrhage, with systolic blood pressure < 90mmHg or requiring blood transfusion.
15% or > body surface areas.
Major burns of the face, hands, feet, airway, or perineum.
Experienced, or had great potential to experience injury to the spinal cord, spinal column, or neurological deficit.
Face or neck injury with unstable or potentially unstable airway which might require advanced airway procedure.
CRAMS score of 8 or less.
Age < 5 years with multiple traumatic injuries.
Respiratory rate < 10 or > 30 breaths per minute.
Heart rate < 60 or > 120 beats per minute.
MEDICAL PATIENTS
Respiratory arrest within the past 12 hours
Cardiac arrest within the past 12 hours
Acute respiratory failure not responsive to initial therapy.
Continuous intravenous vasoactive medications
Mechanical ventricular assist.
Continuous intravenous anti-dysrhythmia medication.
Cardiac pacemaker
Mechanical ventilator support.
Risk of Having an unstable airway
Acute deterioration in mental status
Invasive therapy for hypothermia
Intra-aortic balloon pump
Arterial line
Indwelling pulmonary artery catheter
Intracranial pressure monitor
Respiratory rate , 10 or > 30
Heart rate < 50 or > 150
Systolic blood pressure < 90mmHg or > 200mmHg
Acidosis with pH < 7.2
Transport in a critical care environment to medical center that can perform organ transplantation or procurement.
Acute myocardial infarction that requires therapy or diagnostic procedures not available at the referring hospital.
Cerebrovascular accident in evolution that requires therapy or diagnostic procedures not available at the referring hospital.
Seizure not controlled at referring hospital.
High-risk obstetrical condition.


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