Choosing an Air Ambulance: Questions to Ask

What are the company's qualifications? Is the aircraft owned and managed by the company or is the flight brokered?

Industry standards: There are no industry standards. Many owner-operated services are safe. Brokers are agents who do not own or operate aircraft. They arrange ambulance flights and may add an additional fee. Brokers often select air ambulance companies by the lowest price. It is difficult to tell the brokers from the owner/operators based on their ads. The local office of the Better Business Bureau will check for any reports that have been filed about a specific company.

Mayo MedAir standards: Mayo MedAir works closely with an inspected, safety-reviewed aircraft operator to offer a Citation V jet. This aircraft is used for most domestic and other North American flights. For long distance flights and international flights, Mayo MedAir contracts with aircraft operations that also comply with Mayo Clinic's rigorous quality and aviation standards. An independent aviation auditor annually reviews Mayo MedAir and the aircraft operators it uses.

What is the company's safety record? Has it had any FAA violations?

Industry standards: Most companies have outstanding safety records.

Mayo MedAir standards: Patients can be assured of the safety of the Mayo MedAir transport program because of the annual safety audits and strict internal quality, safety standards and accreditation by the Commission on Accreditation of Medical Transport Services (CAMTS). Mayo MedAir has had no FAA violations.

What type of aircraft will be used? Does it have the ability to fly in all weather? Is the cabin pressurized? What guarantee is there that the plane indicated will actually be the one used?

Industry standards: A variety of aircraft--from very small, non-pressurized cabin aircraft to larger planes--are used throughout the industry.

Mayo MedAir standards: Mayo MedAir uses only pressurized all-weather aircraft that are dedicated to medical transport use, meaning that all equipment necessary for a flight is always checked and available in the cabin, and that the aircraft cabin is ideally suited for medical transportation and not used part-time for charter or ferrying freight. Pressurized aircraft can fly above cloud level, ensuring a smooth ride in most weather conditions. Interiors are of sufficient size to ensure comfort and quality care. In nearly all cases, Mayo MedAir has room available for a family member or guardian to travel along at no additional charge.

What are the qualifications of the pilots?

Industry standards: Minimal federal regulations allow some aircraft to be operated by a single pilot with a minimum of 1,200 hours total flying time as pilot-in-command. No requirements exist for high-density traffic areas.

Mayo MedAir standards: Mayo MedAir requires two pilots for each flight. Mayo MedAir pilots are full time team members dedicated to emergency medical services (EMS) and do not fly other missions. The pilot-in-command must have a minimum of 3,000 hours total flying time with at least 1,800 in a multiengine aircraft. Mayo MedAir also requires a minimum of three years experience flying in high-density traffic areas. The requirements for the second pilot are similar, but less stringent.

Is the air ambulance company a member of the Commission on Accreditation of Medical Transport Services (CAMTS)? Is it CAMTS certified?

Industry standards: Membership varies throughout the industry. In the absence of state and federal regulations, membership in CAMTS can ensure that minimum safety and competency standards are being met. Many for-profit companies may opt not to become CAMTS accredited because there are costs and time commitments associated with attaining this badge of quality and safety.

Mayo MedAir standards: Mayo MedAir is certified by CAMTS, and the only such certified program in the state of Minnesota, and one of only a few air ambulance services worldwide who have made this commitment to safety and quality. To receive accreditation, the service is evaluated on safety standards, education, equipment, staffing, communications, maintenance and administration.

What are the qualifications of the transport team? Have they had any special training?

Industry standards: There are no federal requirements regarding the medical qualifications of the flight team. Frequently, physicians-in-training are allowed to fly in place of a fully qualified physician.

Mayo MedAir standards: All Mayo MedAir transport nurses, respiratory therapists and other specialists work at Mayo Clinic and are experienced in critical-care medicine. Transport paramedics work at Gold Cross, a Mayo Clinic Medical Transport ground ambulance service. Transport nurses and paramedics are certified in advanced life support. Specialized teams are available for both pediatric and neonatal care. All team members are trained in mandatory flight safety. The flight team is selected based on the patient's needs. The same is true of equipment--from automatic external defibrillators to neonatal transporters--all matched to the patient's current and potential needs. These team members are also dedicated medical transport professionals and are not simply pulled from another medical unit when needed for a flight.

Is there a medical director?

Industry standards: There are no federal laws requiring air ambulance companies to employ a medical director. A physician may or may not be involved in the transport.

Mayo MedAir standards: The medical director of Mayo MedAir is a Mayo Clinic physician trained in emergency medicine and aeromedical transport. This physician oversees all training programs and is responsible for the overall quality of the service. Either the medical director or a physician in emergency medicine always is available for discussion and consultation when arranging a transport. All flights by Mayo MedAir teams follow medical guidelines and protocols developed in conjunction with a physician, and are also reviewed by a physician after the flight to ensure quality control.

Will the health care team be in contact with a hospital during the transport?

Industry standards: There are no federal requirements that a transport team remain in contact with a hospital during transport.

Mayo MedAir standards: Mayo MedAir's medical flight team stays in close contact with physicians and others at Saint Marys Hospital Emergency Room, part of Mayo Clinic. In the event there is a medical emergency or unexpected complication, or should a patient's condition worsen during flight, a Mayo Clinic physician can communicate with the medical transport team via two-way radio or air phone during flights. There is also electronic communication in the form of email and text messages with the receiving hospital when appropriate.

What equipment will the team carry, and will a full complement of drugs, monitors and oxygen be provided?

Industry standards: There are few federal requirements that specify what equipment or drugs must be carried.

Mayo MedAir standards: Mayo MedAir's flight team carries a full complement of critical drugs, monitoring equipment and oxygen. Highly specialized supplies and equipment, ranging from basic supplemental oxygen to an advanced neonatal transporter unit, are provided when patients have complex medical needs. Equipment, medications and training of crewmembers is comparable to that of a critical care unit or emergency department at a hospital.

How many health care team members go on the flight?

Industry standards: There are no requirements that specify how many team members must accompany a transport. Many companies provide only one health care specialist.

Mayo MedAir standards: Mayo MedAir selects a team of at least two critical care medical professionals. This team is based on the medical needs of each patient. This ensures that there are adequate personnel on board to treat a medical emergency and the training and preparation should the patient's condition worsen.

What is the cost? When is payment required?

Industry standards: Costs vary greatly, and price alone is not an indicator of quality. Costs are seldom covered by insurance. Many services require full payment in advance.

Mayo MedAir standards: We provide cost estimates in advance, at the time of your call. We can also assist you in filing insurance claims and obtaining any necessary pre-authorization, if your insurance plan covers air ambulance service. Please keep in mind; in most cases full payment is required at the time of service and in many cases not covered by insurance.