Indications for Air Medical Transport Activation

Consider Air Medical Transport for children with:

  • Asthma, croup, bronchiolitis, pneumonia or other respiratory conditions who:
    • are ventilated or in imminent need of ventilation
    • are intubated or in imminent need of intubation
    • require more than 40% oxygen to maintain Saturations 94%
    • require hourly or more frequent aerosols
    • have visible respiratory distress and increased work of breathing
    • have a respiratory or metabolic acidosis on blood gas analysis
    • have an upper airway obstruction, mediastinal mass or foreign body
  • Sepsis and signs of manifest or impending shock, particularly those with immune suppression.
  • Unstable cardiac conditions including arrhythmias, heart failure, unstable or unexplained cyanosis.
  • Status epilepticus, coma, meningitis, or increased intercranial pressure.
  • Unstable metabolic conditions including diabetic ketoacidosis, hepatic or renal failure, or inborn errors of metabolism.
  • Significant head or spinal injuries, cardiothoracic injury, limb amputation, burns, smoke inhalation, near drowning or multi-system trauma.
  • Drug ingestions that may require dialysis or life support.
  • Rare life threatening systemic conditions such as Hemolytic Uremic Syndrome, Stevens-Johnson Syndrome, or Henoch Schoenlein Purpura.

Consider the following when triaging children:

  • Children with life threatening injuries can look deceptively well on first inspection.
  • Head injured children with poor initial exams (e.g. fixed and dilated pupils) are often postictal and have better prognosis than anticipated.
  • Respiratory fatigue and failure can mask respiratory distress and other signs and symptoms.
  • Blood pressure in septic children is often well maintained until shock is advanced.
  • Hypothermia and cold water immersion may prolong ischemic survival time: no child should be declared dead until rewarming is accomplished.

This list is not all-inclusive and provides only general guidelines. Feel free to consult with the LifeFlight Paediatric< medical control physician (Paediatric intensivist on call at IWK) about potential air transport patients by calling the AMT and Trauma Line at 1-800-743-1334.