Canadian Transport Medicine: Waypoints and Destinations

Northern based bush planes have been used as air ambulances since the early 1900s. [...]air ambulances became a mixture of the commandeering of space on scheduled flights to the use of bush planes to an ever-expanding use and integration of helicopters. In all cases, the leading systems have evolved critical care capability, including advanced airway management, standing orders, and medical directives that allow near-ICU interventions and the ability to “patch” with or have on-board an emergency physician and/or intensivist with pediatric and adult care capability. Programs in Canada varied in governance models, funding availability, type of aircraft, geographical response, safety requirements, clinical levels of training, and credentials of healthcare providers to name a few. Air ambulance systems may also play a role in health maintenance and prevention of disease by projecting screening and interventions into remote settings, in a manner analogous to community paramedicine in urban centers.