As increasing numbers of older people travel internationally, air ambulance providers face the challenge of caring for patients with increasingly complex medical needs.
A retrospective research study examining international medical repatriation missions conducted by Fox Flight Air Ambulance, a Toronto-based medical transport provider, has been published in Air Medical Journal. The study, led by Fox Flight Medical Director Dr. Raymond Kao, examines patient transports conducted by the company between 2009 and 2024.
Kao and his colleagues analyzed data from 3,905 individual patient transports. Most patients included in the study were over 60 and had a range of medical conditions, including orthopedic trauma as well as cardiovascular, neurovascular and infectious diseases. The retrospective observational cohort study extracted chart data relating to demographics, diagnoses, transport modality, team composition and medical interventions.
”"The objective of the study was to describe the patient demographics, clinical indications, transport characteristics and in-flight events associated with international fixed-wing air medical repatriations,"
Dr KaoMedical Director - Fox Flight
“There is relatively limited research focused specifically on this area, particularly research involving a cohort of this size. We had a substantial amount of archived data available, so we felt it would be useful to analyze and share it.
“There is relatively limited research focused specifically on this area, particularly research involving a cohort of this size. We had a substantial amount of archived data available, so we felt it would be useful to analyze and share it.”
Through subgroup analysis, the study identified significant associations between in-flight interventions and mechanical ventilation, team composition and age group. Independent predictors of in-flight events included age, orthopedic/trauma diagnoses, neoplasm-related diagnoses, oxygen therapy and invasive mechanical ventilation. The findings may help inform risk assessment, team composition and operational planning for international medical repatriation missions.
“The air ambulance platform is unique because the medical team is limited in what it can do,” said Kao. “If a patient’s condition changes or deteriorates during a transfer, the team cannot easily access additional diagnostic testing or specialist consultation. That makes careful pre-flight assessment particularly important, including understanding the patient’s condition, selecting an appropriately experienced medical team and anticipating potential changes during the flight.”
Kao said he hopes the study will encourage other air ambulance providers to examine their own transport data and contribute to a broader body of research in the field.
The need for research in this area will only grow as international travel increases and travellers become older and medically more complex. The study notes that international travel volumes are projected to reach 1.8 billion trips annually by 2030. At the same time, changes in traveller demographics and medical complexity, along with operational and logistical challenges, will place additional demands on air ambulance services.
Says Kao: “This is going to be a challenge for years to come, because as more older people travel, some will experience falls, pneumonia and other medical problems while away from home. The more data we can generate as an industry to better understand these patients and the challenges associated with transporting them, the more informed our approach to their care can be.”
A link to the Air Medical Journal article can be found at https://airmedicaljournal.com
Dr. Raymond Kao is a Professor of Medicine at Western University and an internist and critical care physician at London Health Sciences Centre. He has served as Medical Director of Fox Flight Air Ambulance since its inception and completed 42 years of Canadian Forces service. He holds an MBA and MPH.
About Fox Flight
Founded in 1997, Fox Flight Inc. is a Canadian air ambulance company providing international, 24-hour, emergency medical transport, bed-to-bed stretcher evacuation and patient escort services on commercial flights. Fox Flight employs a staff of fully licensed physicians, nurses and respiratory therapists as well as highly experienced pilots and aviation maintenance technicians. The company’s fleet of dedicated, fixed-wing air ambulances consists of specially configured jets equipped with the latest in advanced intensive care medical technology. Fox Flight’s head office and hangar facilities are located in Toronto.
To learn more, visit our website: www.foxflight.com
Media Inquiries:
frank.condron@foxflight.com
