Air Medical Journal最新文献

{"title":"Operation of Doctor Helicopters in Eastern Shizuoka Prefecture During the Tsunami Caused by the Massive Earthquake Near the Kamchatka Peninsula","authors":"Youichi Yanagawa MD, PhD","doi":"10.1016/j.amj.2025.09.002","DOIUrl":"10.1016/j.amj.2025.09.002","url":null,"abstract":"<div><div>On July 30, 2025, at approximately 08:25, a magnitude 8.7 earthquake occurred near the Kamchatka Peninsula. Although the earthquake itself caused no direct damage in eastern Shizuoka Prefecture, a tsunami was predicted to reach Japan, prompting the issuance of a tsunami warning. In response to the forecast—predicting tsunami heights of up to 3 m in eastern Shizuoka—operations of the physician-staffed helicopter were relocated to an inland landing site, away from the coastal area, to ensure the safety of patients, medical personnel, and the aircraft. To the best of our knowledge, no similar operational reports have been published in English-language medical literature. This report was therefore compiled as a reference for future documentation and disaster preparedness.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 1","pages":"Pages 77-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Ventricular Devices in Air Medical Retrievals","authors":"Anita Wall BNSc, PGCertNSc (Int Care), DipMid, MAdvNPrac, PGCertNSc (Clin Teach), Grad Cert in Education ,&nbsp;Clinton Gibbs MBBS, FACEM, MPHTM, DipDHM, PGCertAeromedRet ,&nbsp;Lachlan Quick MBBS, FACEM, FCICM ,&nbsp;Jan Sadewasser MBBS, FACEM, FRCEM, AFACAsM ,&nbsp;Katie Clift MBChB, MRCS, FRCA, FANZCA ,&nbsp;Richard C. Franklin PhD, MScoSci, FARLF, PHFAA","doi":"10.1016/j.amj.2025.08.004","DOIUrl":"10.1016/j.amj.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>Describe the clinical characteristics of patients with an external ventricular drain (EVD) air medically retrieved.</div></div><div><h3>Methods</h3><div>A retrospective chart audit of adults with an EVD air medically retrieved between January 2018 and June 2022 was conducted using the Retrieval Services Queensland database. Patients with a diagnosis of subarachnoid hemorrhage were identified, and then a manual review was conducted to identify EVD cases.</div></div><div><h3>Results</h3><div>A total of 60 patients met the review criteria. However, 34 patients did not have an EVD in situ, 1 was not transported, and 2 charts were non-retrievable, leaving 21 patients in this review. Of the patients, 76% were mechanically ventilated and 10% had no EVD drainage (suspected to be blocked). Blood pressure fluctuations occurred in 67% of the cases (79% during flight). Separate analgesia/anesthetic infusions were administered in 75% of the patients, with 83% requiring rate increases and 100% requiring boluses for increases in blood pressure. Hypertension in 3 patients occurred post-EVD being turned off and resolved when EVD was turned back on, and bolus sedation/analgesia was provided.</div></div><div><h3>Conclusion</h3><div>The air medical transport of patients with an EVD is a low-frequency transfer. Therefore, the use of clinical practice guidelines will enable best practice assessment and management.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 1","pages":"Pages 34-38"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Comparison of the Agreement and Accuracy Between Paramedic and Hospital Diagnosis” Air Medical Journal, Volume 41 (2022), Pages 228-232","authors":"Mahdi Mokhtari","doi":"10.1016/j.amj.2025.10.001","DOIUrl":"10.1016/j.amj.2025.10.001","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 1","pages":"Page 87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Development and Validation of a Weight Prediction Tool for Patients With Obesity Undergoing Critical Care Transport Using Width and Arm Circumference","authors":"Kenneth Williams MD, MSc ,&nbsp;Michael Peddle MD ,&nbsp;Justin Smith BHA, MBA ,&nbsp;Mahvareh Ahghari MEng ,&nbsp;Brodie Nolan MD, MSc","doi":"10.1016/j.amj.2025.09.004","DOIUrl":"10.1016/j.amj.2025.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>Obesity rates are rising, affecting health care systems and causing potential delays in critical care transfers. Accurate weights are important for critical care transport to ensure the appropriate transport asset is selected and dispatched in a timely fashion. Inaccurate weight measurements can lead to various unnecessary delays, including not sending appropriate nonbariatric assets, delays due to secondary dispatch, and delays due to systemic overuse of these bariatric capable assets. The primary objective of this study was to develop and validate a weight prediction tool for patients with obesity undergoing critical care transport. The secondary objective was to compare the performance of this model to the Crandall weight prediction tool.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted, collecting data from patients transported by Ornge air ambulance between May 2022 and April 2023. Adults weighing &gt;100 kg undergoing interfacility transfers were included. Four predictive models, using height, arm circumference, width, and girth measurements, were evaluated against actual patient weights and analyzed separately for males and females. Model performance was evaluated by mean squared error, mean absolute error (MAE), mean absolute percentage error, <em>R</em>², and F-statistic.</div></div><div><h3>Results</h3><div>The Ornge model using arm circumference and width demonstrated the highest accuracy and stability in predicting patient weight for both males and females. This model exhibited the lowest MAE of 12.2 kg, was within a margin of 20% error 91.2% of the time, and had an overall false negative error of 6.9%, outperforming all other models.</div></div><div><h3>Conclusion</h3><div>The Ornge arm circumference and width-based model offers a reliable method for predicting patient weight in air ambulance settings. Implementing this tool could improve the efficiency and safety of patient transfers by reducing delays caused by inaccurate weight estimations, thereby expediting access to critical care. Further research is recommended to validate these findings in larger and more diverse populations.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 1","pages":"Pages 52-58"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasodilatory Shock—From Initial Resuscitation to Rescue Therapies: Narrative Review and Considerations for Critical Care Transport","authors":"Brittney Bernardoni MD ,&nbsp;Mikko Sayre MD ,&nbsp;Matthew Roginski MD, MPH ,&nbsp;Adam L. Gottula MD ,&nbsp;Alyson Esteves PharmD ,&nbsp;Craig Tschautscher MD, MS ,&nbsp;Michael Lauria MD","doi":"10.1016/j.amj.2025.08.009","DOIUrl":"10.1016/j.amj.2025.08.009","url":null,"abstract":"<div><div>Vasodilatory shock is a critical condition marked by maldistribution of blood flow leading to decreased oxygen delivery and organ dysfunction. Although sepsis is the most well-studied cause, other causes include anaphylaxis, endocrine or neurologic dysfunction, toxidromes, and the post-cardiac arrest or post-cardiopulmonary bypass state. After appropriate volume resuscitation, vasopressors may be added in a stepwise manner targeting a mean arterial pressure of &gt;65 mm Hg to ensure organ perfusion. If a patient does not respond adequately to these initial measures, a “resuscitation checkpoint” can be used as a debiasing strategy to consider other contributing factors to shock. If cardiac dysfunction is present, consider addition of inotropes. Metabolic resuscitation may be accomplished in appropriate patients with corticosteroids, calcium, or sodium bicarbonate. Finally, emerging treatments may be considered for refractory vasodilatory shock, including angiotensin II, methylene blue, and hydroxocobalamin. Overall, this review presents an evidence-based tiered approach to management of refractory vasodilatory shock in critical care transport.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 539-547"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Time to Admission and Mortality in Physician-Led Medical Evacuations in Greenland","authors":"Magnus Nordstrøm Fagerhaug MD ,&nbsp;Oscar Rosenkrantz MD ,&nbsp;Vagn Bach MD ,&nbsp;Jacob Steinmetz MD, PhD","doi":"10.1016/j.amj.2025.06.021","DOIUrl":"10.1016/j.amj.2025.06.021","url":null,"abstract":"<div><h3>Objective</h3><div>Greenland presents unique challenges for medical evacuations due to its vast distances, Arctic weather, and limited infrastructure. The aim of this study was to assess whether the time from booking of an evacuation from any location in Greenland to the patient arrived at Queen Ingrid’s Hospital (QIH) in the capital, Nuuk, was associated with mortality. It was hypothesized that a longer time interval was associated with a higher 30-day mortality.</div></div><div><h3>Methods</h3><div>An observational cohort study was conducted to all medical evacuations attended by physicians from anywhere in Greenland to QIH in Nuuk, Greenland, between January 1, 2020, and July 31, 2024. Data were extracted from travel logs and medical records and included demographic information, evacuation details, and a 30-day outcome period. Logistic regression was used to compute odds ratios (ORs) associating the time interval from booking to admission with 30-day mortality.</div></div><div><h3>Results</h3><div>Of 1303 records of patients identified through the travel logs, 690 patients met the inclusion criteria. The 30-day mortality was 7.5%, with the median time from booking to hospital admission of 7.9 hours (interquartile range 5.1-19.3). The unadjusted OR of 30-day mortality per hour from booking to admission at QIH was 0.99 (95% confidence interval [CI] 0.97-1.01; <em>P</em> = .50) and 1.00 (95% CI 0.96-1.02; <em>P</em> = .73) in the adjusted analysis.</div></div><div><h3>Conclusions</h3><div>In this study of all medical evacuations attended by physicians in Greenland in a 4.5-year period, there was no association between the time interval from booking to hospital admission at QIH in Nuuk and 30-day mortality.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 465-472"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Debriefing in Physician-Staffed Helicopter Emergency Medical Services: A Quality Improvement Study","authors":"Elisa Willoch ,&nbsp;Christian Tappert MD, PhD ,&nbsp;Andreas Krüger MD, PhD ,&nbsp;Helge Haugland MD, PhD","doi":"10.1016/j.amj.2025.06.013","DOIUrl":"10.1016/j.amj.2025.06.013","url":null,"abstract":"<div><h3>Objective</h3><div>In Norway, physician-staffed helicopter emergency medical services (HEMS) provide critical care for patients needing advanced prehospital treatment. To measure the quality of care, 15 quality indicators (QIs) are monitored, including the occurrence of “debriefing,” a discussion aimed at promoting communication, team learning, and safety. At Trondheim HEMS, the “debriefing” quality indicator has been identified as underperforming compared with other Nordic HEMS bases, suggesting missed opportunities for communication and learning. Given that human error is a major factor in adverse events both in medicine and aviation, enhancing debriefing practices may be crucial for improving quality and safety. The objective of this study was to assess the impact of two interventions on debriefing rates.</div></div><div><h3>Methods</h3><div>In this prospective quality improvement study at Trondheim HEMS, HEMS crews recorded debriefing occurrences in a QI database. The primary measure was the debriefing rate per shift, analyzed using statistical process control. Before the interventions, baseline data were collected in a 2-month period. The first intervention involved placing reminder posters in high-traffic areas. The second intervention provided feedback through a continuously displayed chart of debriefing performance, allowing crews to compare their rates to overall trends. Each intervention lasted 2 months, followed by washout periods where interventions were removed to evaluate sustained effects.</div></div><div><h3>Results</h3><div>The first intervention had no significant improvement in debriefing rates. Notable variation between physicians was observed during the first intervention and washout period. The second intervention stabilized the process and increased the average debriefing rate from 58% in the baseline period to 71% during the intervention. This continued during the following washout period.</div></div><div><h3>Conclusion</h3><div>Prominent variation in performance between physicians indicates a lack of framework for debriefing to occur. The increased debriefing rate is still not ideal. Further approaches are needed to improve debriefing practices in the service.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 459-464"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Pandemic Burnout and Staffing Shortages in Pediatric and Neonatal Transport Teams: A Multicenter Survey","authors":"Paul Dahm MD ,&nbsp;Rudy Kink MD ,&nbsp;Michael Stroud MD ,&nbsp;Archana Dhar MD","doi":"10.1016/j.amj.2025.07.006","DOIUrl":"10.1016/j.amj.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the post-pandemic staffing status of interfacility pediatric and neonatal transport teams and the impact of resilience promotion strategies.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was distributed to members of the American Academy of Pediatrics Section on Transport Medicine.</div></div><div><h3>Results</h3><div>A total of 34 teams respond (30.9% response rate) to the survey. Most of them (58.8%) reported post-pandemic vacancies. Of the teams with vacancies, 90% cited a lack of qualified applicants as the reason for being unable to fill the vacant slots (<em>P</em> &lt; .01). Increased turnover was reported by 50% of the teams resulting in change in the on-boarding/orientation process for the new hires. Burnout was identified by 26 of the teams (76.4%, <em>P</em> &lt; .01), and 25 respondents (73.5%, <em>P</em> &lt; .01) reported that they had received training to recognize burnout.</div></div><div><h3>Conclusion</h3><div>In our survey, most of the responding pediatric and neonatal transport teams faced post-pandemic staffing vacancies, primarily due to a shortage of qualified applicants. Our data suggest that there were subsequent deviations from ideal team compositions and alteration in the on-boarding process for new hires, secondary to personnel shortages.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 492-496"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital Whole Blood in Trauma—A Scoping Review","authors":"Catherine M. Kuza MD, FASA, FCCM ,&nbsp;Andrea H. Denton MILS ,&nbsp;Stephanie Streit MD ,&nbsp;Joseph Rossano MD, MS, FAAP, FACC ,&nbsp;Sarita Chung MD ,&nbsp;Joshua M. Tobin MD, MSc","doi":"10.1016/j.amj.2025.07.009","DOIUrl":"10.1016/j.amj.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>The management of blood resuscitation in hemorrhagic shock in trauma patients is evolving. Prehospital whole blood (WB) re-emerged into practice to correct coagulopathy, replace blood loss, and improve survival. This scoping review evaluated the use of prehospital WB in adult trauma patients with hemorrhagic shock.</div></div><div><h3>Methods</h3><div>We performed a literature search using PubMed, Embase, and CINAHL, including studies published between January 2015 and March 2024.</div></div><div><h3>Results</h3><div>A total of 10 studies (n = 9,621) were reviewed. Studies included 2 case series, 1 prospective randomized controlled trial, and 7 observational studies. Eight studies evaluated civilian patient populations (1 non-trauma, 7 trauma) and 2 were military (1 trauma, 1 mixed trauma/non-trauma).</div></div><div><h3>Conclusion</h3><div>Prehospital WB programs are feasible and relatively safe. They may be beneficial in trauma and other populations; however, the reviewed studies are poor in quality and suboptimal in study design. Thus, definitive recommendations cannot be made. Additional studies are required.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 530-538"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Erosion and Evolution of Medical Peer-Review Privilege: A 2025 Perspective for Air Medical and Critical Care Transport","authors":"John R. Clark JD, MBA, NRP, FP-C, CCP-C, WP-C, CMTE","doi":"10.1016/j.amj.2025.08.008","DOIUrl":"10.1016/j.amj.2025.08.008","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 442-445"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}