Regulation - aba.org.il

Regulations

Glossary

Aeromedical escort	Air medical attendant, medical flight crew.
Aeromedical team	Physician, nurse, paramedic having a certificate of completion of a course in Air Transport of Ill and Injured Persons recognized by the Ministry of Health and the Civil Aviation Administration.
Aircraft	Aeroplane, helicopter.
Aircrew	Pilot, copilot, flight engineer.
Escort	Attendant, member of aeromedical team.
Flight crew	Aircrew, passengers’ cabin crew.
Flight physician	Attending flight physician.
Medical flight crew	Team of aeromedical personnel.
Physician	A doctor with any medical specialty, or general practitioner.

Staging of Patients in relation to their medical condition and the risk to Flight Crew and other Air Passengers.

Stage A	An air transported patient having a disease/injury that does not endanger the patient, the flight crew or other air passengers.
Stage A1	An air transported patient having a disease/injury that does not endanger the patient, the flight crew or other air passengersbut requires assistance in moving around, medicine administration and personal needs.
Stage B	An air transported patient having a disease/injury that may require a medical intervention to stabilize his condition or an immediate life-saving procedure.
Stage B1	An air transported patient having a disease/injury that may cause a dysfunction of vital body systems requiring an immediate life-saving procedure, intensive care, ventilation or medication maintain blood pressure.
Stage C	An air transported patient heaving a contagious disease that may endanger the flight crew, the medical team or other air passengers.
Stage D	An air transported patient heaving a mental disease that may endanger the flight crew, the medical team or other air passengers.
Stage P	An air transported paediatric patient.
Stage P1	An air transported premature newborn patient, newborn patient, baby patient or a paediatric patient having a disease/injury requiring intensive care, ventilation or medication to maintain blood pressure.

Patient's Disease / Injury that Contraindicates Air Transport. In Airlines

Post traumatic increased intracranial pressure.
Air pockets within brain cavities.
Acute otitis media or sinusitis.
Pneumothorax without drainage or suspicion of pneumothorax without chest x-ray.
Paralytic ileus.
First 10 days after pulmonary embolus.
First 10 days after myocardial or cerebral infarction (without
complications).
First 10 days after myocardial or cerebral infarction with complications
A patient is permitted to be transported by air when accompanied by a proper medical team with suitable equipment.
A patient that needs 100% oxygen to maintain blood oxygen saturation at sea level, a ventilated patient or a patient receiving medication to maintain blood pressure.
Deep vein thrombosis when inflammatory symptoms are still
present.
First 8 days after major surgery.
Anemia of less than 8 g%.
First 48 hours after a cylindrical limb casting, excluding the
cases in which the cast was incised throughout its length.
Acute glaucoma.
First 24 hours after SCUBA diving.
Acute psychosis.
Contagious disease that may infect other Air Passengers.
*A patient with TB may travel by air only at the end of 2 weeks from the start of treatment and two negative sputum cultures.
A patient refusing to fly.
Pregnancy at the end of 3d trimester (subject to flight time).

In Air Ambulance

The above mentioned contraindications for transportation of patients in airlines are all relative when applied to transportation of patients in an Air Ambulance; they are subject to assessment of the flight physician and operator’s medical advisor.

Requirements for practicing as a medical flight member and rating an aero medical team by the air transported patient’s stage.

An aircraft operator transporting patients shall ascertain that

An escort of an air transported patient, in an airline or an air ambulance aircraft, shall have a certificate of completion of a course in Air Transport of Ill and Injured Persons recognized by the Ministry of Health and the Civil Aviation Administration.
An escort of an air transported patient carries direct responsibility for the patient’s medical care; he/she shall ascertain and act according to all regulations and directives of the Ministry of Health and the Civil Aviation Administration.
The senior escort shall record the data required as indicated in the form in annex 4.
Rating of aeromedical team to fit patient’s stage shall be as follows:

Patient Stage A- Nurse / Paramedic.
Patient Stage A1- A specialist or specializing (graduate stage A) physician.
Patient Stage B – A specialist or specializing (graduate stage A) physician.
Patient Stage B1 – An specialist physician having two year experience in intensive care + a nurse / paramedic.
Patient Stage C – An internal medicine / infectious disease specialist or a physician specializing (graduate stage A) in
one of these specialties.
Patient Stage D – A psychiatrist or a physician specializing in psychiatry (graduate stage A), or a psychiatric male nurse that completed advanced psychiatric training; as indicated by the patient’s problem.
Patient Stage P – A pediatrician or a physician specializing in pediatrics (graduate
stage A), or a pediatric nurse; as indicated by the patient’s problem.
Patient Stage P1 – A pediatric intensive care specialist + a pediatric intensive care nurse.

Israeli Ministry of Health Regulations for Transport of Critically Ill Patients

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