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The Importance of the Pre-Flight Assessment

by Lux Joseph 4. October 2013

During each and every transfer that CME completes for our clients it is important that our medical personnel complete a thorough pre-flight assessment. This is the opportunity in which our medical team confirms all the information they received is accurate and that the arrangements that have been set up meet the needs of the patient. During the pre-flight assessment the nurse or physician communicates directly with the operations staff and makes any adjustments to the travel arrangements. Below is an example of a situation in which the pre-flight assessment altered how the transport was completed.

74 y/o M PT who was on a cruise and fell. Upon docking, Patient was disembarked and taken to the ER. After a workup which showed multiple pelvic fractures and multiple rib fractures he was admitted. He had physical and occupational therapy. Patient had limited weight bearing. No pneumothorax.

Upon arrival of the medical escort, 5 days after the incident, the escort received report that the patient's condition changed. The patient now complained of right upper quadrant pain. He also had an increased WBC and elevated liver enzymes. CXR showed no sign of pneumonia.

The doctor stated that the patient was not going to fly and would be worked up for a possible gallbladder problem; which is unrelated to the original diagnosis. Several diagnostic studies showed gallstones with possible biliary duct obstruction. The physician decided to remove the patient's gallbladder the next day. The transport was delayed.

17 days later the patient had his gallbladder removed, now has an open wound with closure to secondary intention. Here were some complications post op.

  • The patient developed an ileus.
  • The patient is C-diff positive and is on contact isolation.
  • He is on a full liquid diet with TPN supplementation. However, the patient is now able to bear weight and uses a walker.
  • Due to bed rest and atelectasis, the patient is now on supplemental oxygen at 2 LPM and his pulse ox is 95%.

Recommendation for travel is commercial airline, business class, RN escort, oxygen 3 LPM, W/C assist and home oxygen.

The patient did very well throughout the flight. He was in no pain and maintained oxygen sat of 97% or higher on supplemental oxygen. The patient was delivered home pain free, safely and in good condition.

In a recent conversation the Director of Operations at CME stated, “During the pre-flight assessment communication with the medical personnel and our logistics coordinators is critical. Prior to the medical team member arriving, our medical team receives information via medical charts and speaking with the facility. With variation in medical practice around the world, it is essential for the face to face pre-flight assessment. The pre-flight assessment ensures a smooth safe transfer for the patient.”

In our next blog we will share with you a travel story with one of our patients that we transferred and the story of his life. Each patient we transfer has a story to tell and we are fortunate to be able to share it with all of you.

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