Air Medical Journal最新文献

{"title":"General Information","authors":"","doi":"10.1016/S1067-991X(25)00011-2","DOIUrl":"10.1016/S1067-991X(25)00011-2","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Page 5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Reduced-Dose Induction Agents During Endotracheal Intubation in Critical Care Transport","authors":"Kalle J. Fjeld MD ,&nbsp;Alissa M. Bates MD ,&nbsp;Matthew A. Roginski MD, MPH ,&nbsp;Ryan J. Ding ,&nbsp;Alyson M. Esteves PharmD, BCPS, BCCCP","doi":"10.1016/j.amj.2024.11.009","DOIUrl":"10.1016/j.amj.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>Induction agent selection and dose are potentially modifiable risk factors to mitigate postintubation hypotension and hemodynamic collapse. Despite it being a common practice, minimal literature exists to support induction agent dose reduction. Our objective was to evaluate the rate of postintubation hemodynamic collapse with reduced-dose compared to full dose induction agents.</div></div><div><h3>Methods</h3><div>This is a retrospective chart review of adult patients who were endotracheally intubated by a critical care transport team and received etomidate or ketamine for induction. The primary outcome was association of reduced-dose induction agent use (etomidate &lt;0.2 mg/kg or ketamine &lt;1 mg/kg) with postintubation hemodynamic collapse.</div></div><div><h3>Results</h3><div>A total of 304 patients were included; 187 (61.5%) received etomidate and 117 (38.5%) received ketamine. Of these 304 patients, 64 (21.1%) received reduced-dose agents and 240 (78.9%) received full-dose agents. The initial systolic blood pressure and mean arterial blood pressure levels were lower in the reduced-dose arm. Shock index, hemodynamic collapse, and life-threatening hemodynamic collapse did not differ between the groups.</div></div><div><h3>Conclusion</h3><div>In this analysis, there was no difference in rates of postintubation hemodynamic collapse with reduced-dose induction agents when compared with full-dose agents.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 52-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bright Dawn of Neonatal Air Transport in Italy: A Narrative of the Very Early and Pioneering Italian Neonatal Air Transports","authors":"Carlo Bellini MD, PhD","doi":"10.1016/j.amj.2024.10.001","DOIUrl":"10.1016/j.amj.2024.10.001","url":null,"abstract":"<div><div>This article describes the very first neonatal air transports in Italy. The historical documentation comes from the archive of the Italian Air Force and material collected by the Gente del 15° Association, which brings together veterans and supporters of the glorious 15th Search and Rescue Squadron of the Italian Air Force. Four episodes are described, relating to the years 1953, 1955, 1971, and 1981.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 105-110"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humidification and Tracheostomy Care in Transit: A Systematic Review of Current Evidence and Future Directions","authors":"Tiffany S. Stone BS, BSN, RN, CPEN, CFRN ,&nbsp;Cynthia L. Miller RN, MS, CFRN, NRP, CEN ,&nbsp;Jonathan Summey BSRT, NRP, FP-C, RRT ,&nbsp;Russ Bongiovanni RCP, RRT-ACCS ,&nbsp;Erik Nemecek MSN, RN ,&nbsp;Mark A. Merlin D.O. EMT-P, FACEP","doi":"10.1016/j.amj.2024.10.006","DOIUrl":"10.1016/j.amj.2024.10.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Spontaneously breathing tracheostomy patients face unique challenges in maintaining adequate humidification of inspired gases due to the absence of natural humidification provided by the nasal passage and pharynx. This systematic review evaluates the effectiveness of current humidification strategies to identify the best practices, aiming to better understand their potential application in low-humidity environments such as in air medical transport. In adult, spontaneously breathing tracheostomy patients, how effective are current humidification strategies—heat and moisture exchangers (HMEs), cool mist humidification (CMH), and heated humidifiers (HHs)—in maintaining adequate humidification and preventing complications?&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, with a comprehensive search of PubMed, MEDLINE, Cochrane Library, and EBSCO databases for studies published between 2013 and 2024. The inclusion criteria were studies that involved spontaneously breathing tracheostomy patients and evaluated the effectiveness of humidification strategies, whereas exclusion criteria were studies on mechanically ventilated patients and pediatric population and reviews, editorials, and non–peer-reviewed articles. Data from the selected studies were extracted and assessed using the Cochrane risk of bias tool, the Newcastle-Ottawa scale, and an adapted CONSORT (Consolidated Standards of Reporting Trials) checklist for bench studies. A narrative synthesis was performed to summarize the findings due to the heterogeneity of study designs, interventions, and outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 6 studies were included in the review. These studies involved various humidification methods such as HMEs, CMH, and HHs. Results indicated that HMEs generally struggle to provide sufficient humidification, particularly when supplemental oxygen is required. CMH was generally less effective in maintaining adequate humidity levels, requiring more frequent tracheal suctioning due to inadequate humidification. HHs consistently provided the highest humidity levels and were the most effective in reducing respiratory complications and improving patient comfort, even with supplemental oxygen.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The evidence included in this review is limited by the high risk of bias in some studies and the variability in study designs and methodologies. Although none of these studies specifically evaluated the effectiveness of humidification strategies in the unique environment of air medical transports, their findings suggest that the use of HHs is the most reliable method for maintaining adequate humidity levels. This review highlights the necessity of improving humidification strategies to ensure the comfort and safety of tracheostomy patients during air transport. Future research shou","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 99-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"January/February 2025 Forum","authors":"","doi":"10.1016/j.amj.2024.12.004","DOIUrl":"10.1016/j.amj.2024.12.004","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 20-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Helicopter Services and Their Development From a Medical Standpoint: Nepal","authors":"Sanij Singh MBBS, MDGP ,&nbsp;Sagun Shrestha MBBS ,&nbsp;Pritina Nakarmi MBBS ,&nbsp;Rupesh Yadav MBBS ,&nbsp;Suleyman Ulla MBBS ,&nbsp;Sameep Singh MBBS ,&nbsp;Rohendra Pande MBBS, MDGP ,&nbsp;Praphul Kumar Jha MBBS, MDGP ,&nbsp;Bimala Joshi MBA ,&nbsp;Anish Baniya MBBS ,&nbsp;Shruti Thapa BSc, MA ,&nbsp;Sanjaya Karki MBBS, MD, DAvMed","doi":"10.1016/j.amj.2024.09.001","DOIUrl":"10.1016/j.amj.2024.09.001","url":null,"abstract":"<div><div>Nepal is a landlocked country in the heart of the Himalayan region. Its remote villages and mountainous terrain provide a unique set of challenges in health care. As a result, the last decade has seen major developments in the use of helicopters in retrieval medicine. This has helped to improve accessibility to health care in even the most rural areas. Despite the assorted challenges, the helicopter emergency medical service in Nepal is a part of the medical system. This article provides a comprehensive overview of the history of helicopter and air medical services in Nepal.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 30-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Critically Ill Patients With Pulmonary Arterial Hypertension in Transport: A Narrative Review","authors":"Michael J. Lauria MD, NRP, FP-C ,&nbsp;Andrew Merelman MD ,&nbsp;Jennifer L. Thompson MD ,&nbsp;Darren A. Braude MD, MPH ,&nbsp;A. Doran Bostwick MD","doi":"10.1016/j.amj.2024.11.008","DOIUrl":"10.1016/j.amj.2024.11.008","url":null,"abstract":"<div><div>Pulmonary arterial hypertension (PAH) is a unique disease process with a highly complex physiology. Patients with PAH are often on specialized medications that exert specific hemodynamic effects. Furthermore, when they become critically ill, the management strategy can be counterintuitive. Commonly accepted, evidence-based management for the general population, such as fluid boluses in the setting of sepsis, can be harmful to this patient cohort. Often, these patients require highly specialized care at tertiary and quaternary centers, which necessitates critical care transport. Therefore, it is important that critical care transport crews understand the distinctive pathophysiology and management of critically ill patients with PAH.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 73-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Risk Pediatric Mental Health Transports—Improving Barriers to Getting Help: A Standardized Approach to High-Risk Pediatric Mental Health Transports","authors":"Lisa Pruitt RN, BSN, C-NPT, CMTE ,&nbsp;Jennifer Flint MD","doi":"10.1016/j.amj.2024.10.009","DOIUrl":"10.1016/j.amj.2024.10.009","url":null,"abstract":"<div><div>The Children's Mercy Hospital Critical Care Transport (CMCCT) team provides care to a sizable portion of the Midwest United States. CMCCT has seen an increased frequency of pediatric mental health transport requests for patients who are aggressive or at risk of becoming aggressive during interfacility transport. These transport requests often involve long distances and require a medical flight to accomplish safely. CMCCT's multidisciplinary approach and process focus on crew and patient safety to provide compassionate and dignified care, ensuring that this very vulnerable patient population arrives safely at their mental health care institution. This paper describes our patient population, policy, systemic process, and barriers to completing the transport.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 117-120"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milestones and Memories, 1986-2025","authors":"Eileen Frazer","doi":"10.1016/j.amj.2024.12.003","DOIUrl":"10.1016/j.amj.2024.12.003","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 6-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Assessment of a Single Referring-Receiving Hospital Pair to Assess Air Versus Ground Elapsed Time From Transport Request to Arrival at Cardiac Catheterization Laboratory: An Observational Cohort Study","authors":"David Schoenfeld MD, MPH ,&nbsp;Kalon K.L. Ho MD, MSc ,&nbsp;Michael P. McCartin MD ,&nbsp;Christie Fritz MD, MS ,&nbsp;Robert Petcu MD ,&nbsp;Jason Cohen MD ,&nbsp;Carlo Ottanelli BS ,&nbsp;Edward Ullman MD ,&nbsp;Ira Blumen MD ,&nbsp;Stephen H. Thomas MD","doi":"10.1016/j.amj.2024.11.007","DOIUrl":"10.1016/j.amj.2024.11.007","url":null,"abstract":"<div><h3>Objective</h3><div>Timely reperfusion is crucial for improving outcomes in patients with ST-elevation myocardial infarction (STEMI). The impact of transport mode on time to treatment for patients with STEMI over short distances (&lt;10 miles) is not well studied. This study aimed to compare the time from transport request to percutaneous coronary intervention (PCI) suite arrival between helicopter emergency medical services (HEMS) and ground emergency medical services (GEMS) for patients with STEMI.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study involving 22 patients with STEMI transported by either HEMS or GEMS from a single referring hospital to a single receiving hospital PCI suite, located 8 miles apart, from January 2020 to January 2023. Data on transport times were collected from hospital records and Google Maps estimates. We analyzed the time intervals using descriptive and inferential statistics, including mean comparisons and regression analyses.</div></div><div><h3>Results</h3><div>Air transport (HEMS) was significantly faster than ground transport (GEMS) by a mean of 32 minutes (95% confidence interval: 21.1-42.9 minutes). This difference was clinically significant in 50% of the cases. Sensitivity analyses using longer HEMS transport times confirmed the robustness of the findings. No significant changes in transport times were observed over the study period.</div></div><div><h3>Conclusion</h3><div>HEMS may offer time advantages compared with GEMS for short-distance transfers in STEMI cases, though the small sample size limits the robustness of these findings. Further research with larger samples and additional outcome measures is needed to confirm these results and assess the broader implications for emergency medical transport.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 1","pages":"Pages 46-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}