The Foundations of Aeromedical Retrieval (TM5560) course is the
introductory unit in Graduate Certificate of Aeromedical Retrieval course
offered by James Cook University. This subject provides students
with an overview of the knowledge, skills and attitude required for the
successful management of aeromedical retrieval in the Australian and the
In 2019/20 I had the opportunity to spend 18 months working in Africa
with Arusha Medivac (sic), Tanzania's only dedicated air ambulance
service. Operating a single Piper Navajo aircraft well suited to
bush airstrips, the company provides primary retrieval services across
Tanzania and secondary retrievals to tertiary facilities in Nairobi and
Dar Es Salaam. I chose this course to improve my knowledge
base so that I am better equipped to mentor my Tanzanian colleagues in
aeromedical and pre-hospital medicine.
The course was facilitated by Dr. Stefan Mazur and Ms Anita Robertson,
both experienced clinicians in the aeromedical field. It was
delivered online over 15 weeks and consists of seven modules including
the history of aviation medicine, aviation physiology, aeromedical
retrieval systems, risk and expenditure, technical requirements,
co-ordination and clinical governance. Assessment for the course was
two written papers and a two-hour closed-book exam.
Modules 1 and 2 examined the main drivers for the introduction of
aeromedical retrieval services and the growth of these services in
Australia and overseas. Particular attention was given to the
history and development of the Royal Flying Doctor Service and their
model of operations.
Module 3 focused on aviation physiology with particular emphasis on gas
laws and respiratory physiology. Areas covered included the
aetiology and treatment of hypoxia and barotrauma, the effects of
altitude on diving conditions and of flight dynamics on a patient's
condition. Oxygen requirements and delivery calculations were also
discussed. The university's online forum gave many opportunities
for robust discussion regarding clinical considerations and treatment
priorities through a range of case studies.
Running over 3 consecutive weeks, Module 4 compared different models of
aeromedical care, including adult, paediatric and neonatal transports,
pre-hospital, interhospital and long-haul international
retrievals. The use of military assets was examined, including
their capability, tasking arrangements and the differences between
civilian aeromedical services. This unit also considered factors that
influence patient outcomes, contrasting the benefits versus the cost
associated with aeromedical transports and outlining the
decision-making process used to mitigate risks in retrieval operations.
Module 5 looked at the Technical Requirements associated with Retrieval
Medicine, including aircraft characteristics, flight safety and medical
equipment for the aeromedical environment. I was particularly
interested in advances in mechanical ventilator technology having used
a rudimentary ParaPac 200D in Africa. This module also debated the
ideal skills mix for flight crews.
Module 6 investigated the clinical co-ordination of retrieval flights
and the key factors that influence prioritisation and tasking of
aeromedical retrieval assets. The use of information technology in this
context was also examined.
Finally, Module 7 reviewed the clinical governance requirements for an
aeromedical service including medico-legal issues, international
standards and accreditation, systems-based approaches to quality
management, training and research and special issues associated with
international aeromedical retrievals.
While an experienced road paramedic, the course addressed many of the
gaps in my knowledge of aviation physiology and retrieval operations.
The information I learned through this course has allowed me to
continue to support Arusha Medivac from Australia during the current
international border closures, by assisting the organisation with the
development of their operating procedures and clinical practice
guidelines, building professional networks and continuing to source
donations of medical equipment.
I would like to thank the Aeromedical Society of Australasia for
providing the Professional Development Scholarship and would encourage
future applicants to take advantage of this generous opportunity.
Photos: James Cook University campus | Operations in
Africa, Retrieval from Selous National Park.