By Glenna Murdock, RN, contributor
Jennifer Garr, RN, BSN is a nurse who never sees her patients. From the Global Response Center of MedAire, Inc. in Tempe, Arizona, Garr and 11 other RN case managers direct care for clients worldwide who do not have immediate access to medical care on the ground. Working 12-hour shifts, two or three nurses are available in the response center around the clock.
MedAire is a service company that contracts with commercial airlines, corporate and private aircraft, luxury yachts and commercial shipping vessels to provide remote medical advice to passengers and crew when a doctor is unavailable on site.
MedAire’s mission statement, Protecting life with Expert care, Everywhere, provides a condensed explanation of what the company provides. In addition to remote consultations and directives, experts in many medical disciplines instruct in-depth training of crewmembers as emergency first responders. The training is specific to the crew’s environment, whether it is at altitude or on the sea, and goes beyond basic CPR.
Garr, Manager of Medical Operations, stated that while the nurses’ main function at MedAire is triage, they are responsible for a number of duties within three areas: medical fit-to-fly assessments, passenger assistance services and crew support.
Falling into the fit-to-fly category are airport medical assessments that resulted in 12,000 calls for assistance last year.
“Gate agents, who visually assess passengers as they board airplanes, may question a passenger’s fitness to fly,” Garr said. “Before allowing that passenger to board, the response center is called and we evaluate the specifics of the passenger’s condition. We are schooled in aviation guidelines to determine whether a passenger’s condition will deteriorate in flight.”
To ensure their health will not be compromised by altitude, MedAire nurses also provide assistance prior to travel for airline passengers who have existing medical conditions, primarily for those who require oxygen on the ground.
“We consult with the passenger and their physician and consider how altitude will affect the passenger’s need for oxygen,” Garr explained. “We also facilitate the passenger having the necessary paperwork and we notify the airline of the passenger’s fitness to fly and the amount of oxygen he will need.”
MedAire nurses do not handle in-flight emergencies of either passengers or crewmembers. Calls in those cases go directly to MedAire’s MedLink response center in the emergency department at Banner Good Samaritan Hospital in Phoenix. MedAire contracts with practicing Board certified physicians who take in-flight calls while they are on duty in the ER.
The nurses do, however, support the crew when medical issues occur while on layovers. They may advise in cases as simple as a sore throat or blocked ears, or for more serious conditions, such as the symptoms of appendicitis. The RNs determine the level of care needed and then coordinate the crewmember getting that care. If the nurses want to consult a physician, they have immediate access to the MedLink medical staff.
“The crewmembers are away from home, they have no family with them and don’t know who to call,” Garr said. “They only know us. We are their lifelines. In a sense, we become their family. A case may remain active for one to five days or, if the illness or injury is serious, we may follow up for six months or even a year.”
The RNs monitor the crewmembers’ situation and work with a treating physician to make a determination as to when they are safe to board a plane, whether as a working crewmember or as a passenger.
Like all MedAire case managers, Garr, a graduate of Seattle Pacific University, had a background as an emergency room nurse before joining the MedAire team of RNs. She continues to work one or two shifts monthly in an emergency department in order to keep her skills honed.
“This job has increased my knowledge of health care worldwide,” she said. “Because the quality of health care varies so greatly around the world, I have to be aware of what is available and where it is available.”
The satisfaction Garr finds in her job falls under the broad heading of making a difference.
“I know for a fact that our nurses make a difference in passenger health,” Garr said. “We make a difference by decreasing the need to make an unscheduled landing, which is costly and negatively alters the schedules of the crew and passengers. We make a difference for the crew members who are ill. We aren’t at their bedside but we are on the phone with them, calming them down, giving encouragement and explaining their conditions to them.
“We receive many compliments from crewmembers. They are appreciative of our looking out for them, for taking care of the details of their treatment and especially for getting them back home. Ultimately, that is our goal.”
MedAire serves more than 2,000 clients worldwide. Its nursing staff plays an integral part in providing the high standard of care on which MedAire prides itself.
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