Evaluation of a Team-Based Flight Risk Assessment Tool in Air Medical Transport

Area of Science:

• Emergency Medicine
• Aviation Safety
• Occupational Health

Background:

• Fatigue is a significant issue in emergency medical services (EMS), particularly in air medical transport.
• Existing fatigue assessment tools for EMS lack robust evidence of reliability and validity.
• There is a need for effective methods to identify high-risk factors contributing to fatigue in this demanding field.

Purpose of the Study:

• To evaluate the utility of a team-based Flight Risk Assessment Tool (FRAT) in enhancing safety and patient care within air medical transport.
• To determine if the FRAT can effectively identify and address fatigue-related risks in flight crews.

Main Methods:

• Retrospective analysis of 1,919 team-based FRAT scores from a critical care transport program in 2021.
• FRAT assessed professional experience, stressors, sleepiness, and work conditions at shift start.
• Scores were correlated with operational outcomes: intubation success, quality assurance flags, and scene time.

Main Results:

• The FRAT identified 281 instances requiring mitigation, with 259 mitigation strategies implemented.
• No statistically significant associations were found between FRAT scores and first-pass intubation success.
• The FRAT scores did not correlate with the presence of quality assurance flags or time spent on scene.

Conclusions:

• The team-based FRAT successfully prompted mitigation activities in a significant number of cases.
• The study did not find evidence that the FRAT scores were associated with the specific quality measures analyzed.
• Further research is needed to refine fatigue assessment tools and their impact on objective safety outcomes in air medical transport.