Air Medical Journal最新文献

{"title":"How to Handle In-Flight Death in International Patient Repatriation and Air Ambulance Operations","authors":"Alex Veldman MD ,&nbsp;Michael Diefenbach MBA ,&nbsp;Marcus Tursch MD ,&nbsp;Nico Lange JD","doi":"10.1016/j.amj.2024.06.006","DOIUrl":"10.1016/j.amj.2024.06.006","url":null,"abstract":"<div><p>In-flight cardiac arrest is a rare event that occurs at a rate of approximately 1 event in 3.8 to 4.7 million commercial airline passengers and at a rate of approximately 1 event in 1,500 to 3,000 patients transported by fixed wing international air medical transport. Only 13% to 19% of victims of in-flight cardiac arrest can be successfully resuscitated. The arrival of an aircraft with a deceased patient/passenger on board triggers a country-specific procedure that focuses on public health and medicolegal considerations. In most jurisdictions, these procedures are detailed in the respective national Aeronautical Information Publication, which are commonly based on the International Civil Aviation Organization International Standards and Recommended Practices, Annex 9 to the Convention on International Civil Aviation. Awareness among medical and flight crews on such procedures will support appropriate documentation of the event and enable effective cooperation with the relevant local authorities.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 457-461"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1067991X24001536/pdfft?md5=b7a03dd5e759d8e7a0b1698a232eeae4&pid=1-s2.0-S1067991X24001536-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700634","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":"An Air Medical Approach to In-Flight Cardiac Arrest Management","authors":"","doi":"10.1016/j.amj.2024.05.006","DOIUrl":"10.1016/j.amj.2024.05.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;Cardiac arrest during air medical transport is a complex and challenging issue, with unique factors such as limited physical space with restricted access to patients and equipment, small transport teams, limited resources, clinical isolation, effects of altitude, and the need for rapid decision making. The American Heart Association proposed 10 steps to improve outcomes of in-hospital cardiac arrest and serve as the framework for this article. This article aimed to explore these unique challenges and propose a contextual approach that might serve as the basis for improvement projects looking to improve outcomes for affected patients.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This article represents a narrative review of the subject to consolidate the issue of cardiac arrest in the air medical setting specifically. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension was used to guide the search strategy and methodology. The applicable items in the literature were selected through searches of the PubMed and Google Scholar databases. The Medical Subject Headings search terms used included “cardiopulmonary resuscitation” or “heart arrest” and “air ambulance” or “air medical transport,’’ yielding 477 results. Screening for relevant results for inclusion was based on the relevance of the title or abstract. Articles not written in English or German or addressing commercial air transport were excluded. The reference lists of the included articles were searched for additional literature not included in the original search.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Three distinct phases are arbitrarily identified by the authors, and the results are discussed under the following headings: pre-arrest, intra-arrest, and post-arrest phases. The pre-arrest phase is characterized by a wide array of concepts such as appropriate goals of care, advanced preparation and action, good clinical governance, patient assessment and handover, system design and ergonomics, sterile cockpit management, appropriate alarm management, and contingency planning in the case of failed resuscitation. The intra-arrest phase is characterized by the contextualization of the usual resuscitation approach, and specific recommendations for immediate nonresuscitative actions, history, hazards, help, airway, breathing, circulation, drugs, and reversible causes are suggested. The post-arrest phase highlights the vulnerable nature of the post–cardiac arrest patient in the air medical setting. Specific considerations regarding postresuscitation care and practitioner well-being are highlighted.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;This article outlines a systematic approach to various physical, clinical, mental, and systemic factors that can be used during various phases of the transport journey as well as the individual patient journey. This overview sensitizes individual clinicians or program directors to the factors needing consideration wh","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 383-389"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1067991X24001044/pdfft?md5=06bf51fc5f8bd6c6ff375287862d105a&pid=1-s2.0-S1067991X24001044-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401967","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":"Flexible Fiber-Optic Scope Use in Retrieval Medicine: A Case Series","authors":"Thomas Brown BMBS ,&nbsp;Oliver Cook MBBS ,&nbsp;Clare Hayes-Bradley BSc, MBBS","doi":"10.1016/j.amj.2024.06.004","DOIUrl":"10.1016/j.amj.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>The use of flexible fiber-optic scopes is increasing across critical care specialities, but there is limited literature on their use in retrieval medicine. This study aims to describe a case series in which flexible fiber-optic scopes were used by New South Wales Ambulance Aeromedical Operations critical care teams.</p></div><div><h3>Methods</h3><p>A retrospective case series was performed in our service from January 1, 2019, to December 31, 2021. We searched our electronic medical retrieval database for the terms “aScope,” “Awake Fibreoptic Intubation (AFOI),” “Fibreoptic Intubation (FOI),” and “Nasal Endotracheal Tube (ETT)” to identify when a flexible fiber-optic scope was used.</p></div><div><h3>Results</h3><p>There were 16 uses of flexible fiber-optic scopes during the study period. The most common procedure was awake nasal fiber-optic intubation, which was performed during 9 cases, 7 of which were successful. Other procedures performed included 4 cases of intubation through a supraglottic airway, 1 case of an asleep fiber-optic intubation, 1 case of flexible nasoendoscopy for upper airway assessment, and 1 case of fiber-optic bronchoscopy via tracheostomy. These procedures were performed by anesthetic, emergency and intensive care doctors. This case series describes 4 of these cases in more detail.</p></div><div><h3>Conclusion</h3><p>This case series demonstrates a variety of procedural and diagnostic uses for flexible fiber-optic scopes in retrieval medicine. These procedures can have an important bearing on decision making and patient management. The training and clinical governance provided by our service in this skill appears to be safe and robust with high success rates of awake fiber-optic intubations.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 427-432"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699519","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":"Psychomotor Vigilance Testing on Neonatal Transport: A Western Australian Experience","authors":"","doi":"10.1016/j.amj.2024.05.003","DOIUrl":"10.1016/j.amj.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to assess whether undertaking retrieval was associated with fatigue independent of sleep and circadian disruption. It also aimed to assess the feasibility of routinely measuring the psychomotor vigilance test (PVT) on neonatal transport. Fatigue is associated with impaired clinician performance and safety. The association between shift work, sleep deprivation, and circadian disruption is well established. No studies have specifically assessed the independent effect of the retrieval environment on fatigue.</p></div><div><h3>Methods</h3><p>Medical and nursing staff of the neonatal retrieval team were prospectively recruited over a 12-month period. Simple reaction times (RTs) were recorded at the start and end of a day shift using a validated 3-minute PVT.</p></div><div><h3>Results</h3><p>The end-of-shift RT increased (not significant) by 6.38 milliseconds (95% confidence interval [CI], −2.17 to 14.92 milliseconds; <em>P</em> = .149) when retrieval was undertaken. A 1-millisecond increase in RT increased the odds of being in a subjective sleepy category by 0.57% (95% CI, 0.0036-0.0078; <em>P</em> &lt; .001). Consuming caffeine during the shift increased the mean RT by 16.26 milliseconds (95% CI, 4.43-28.1 milliseconds; <em>P</em> &lt; .01).</p></div><div><h3>Conclusion</h3><p>The RT of participants exposed to the retrieval environment was not significantly increased. Further studies are needed to consolidate these results as well as to further assess longer-range air medical retrievals.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 401-405"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279260","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":"Erratum to ‘Air Medical Transport of a 12-Year-Old Girl With Cerebral Gas Embolism Due to Helium Inhalation’ [Air Medical Journal 42/5 (2023) 377- 379]","authors":"Emine M. Tunc MD ,&nbsp;Richard B. Utarnachitt MD, MS ,&nbsp;Andrew Latimer MD ,&nbsp;Ashley Calhoun RN, BSN, CCRN, CFRN, EMT-B ,&nbsp;Danielle Gamache RN, BSN, CFRN, CCRN, CEN, CPEN, EMT-B ,&nbsp;Jessica Wall MD, MPH, MSCE, NRP","doi":"10.1016/j.amj.2024.08.001","DOIUrl":"10.1016/j.amj.2024.08.001","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Page 466"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1067991X24001652/pdfft?md5=5c9171e294006e1020568b31cdd55b1f&pid=1-s2.0-S1067991X24001652-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239839","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":"General Information","authors":"","doi":"10.1016/S1067-991X(24)00175-5","DOIUrl":"10.1016/S1067-991X(24)00175-5","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Page 373"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239080","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":"Air Medical Transport of a 12-Year-Old Girl With Cerebral Gas Embolism Due to Helium Inhalation","authors":"James R. Holm MD, FACP, FACEP, FUHM,&nbsp;Neil B. Hampson MD, FUHM","doi":"10.1016/j.amj.2024.07.001","DOIUrl":"10.1016/j.amj.2024.07.001","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Page 374"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841823","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 Impact of the Coronavirus Disease 2019 Pandemic on Helicopter Emergency Medical Services","authors":"Roberta Pireddu ,&nbsp;Francesca Bottega ,&nbsp;Maria José De la Rosa ,&nbsp;Serena Ruberti ,&nbsp;Angelo Giupponi ,&nbsp;Andrea Mina ,&nbsp;Luca Filetici ,&nbsp;Giovanni Cipolotti ,&nbsp;Alberto Zoli ,&nbsp;Carlo Signorelli","doi":"10.1016/j.amj.2024.07.004","DOIUrl":"10.1016/j.amj.2024.07.004","url":null,"abstract":"<div><p>The coronavirus disease 2019 pandemic has profoundly affected the Lombardy healthcare system. Although air transport of critical patients played a crucial role, there are still gaps in understanding how the pandemic impacted helicopter emergency medical services (HEMS). A retrospective observational analysis was performed using data from the regional emergency-urgency online portal. The investigation focused on patients airlifted by helicopter to the Lombardy emergency departments from January 1, 2019, to December 31, 2021. A total of 12,953 admissions to the emergency departments have been recorded (5,733 in 2019, 3,550 in 2020, and 3,670 in 2021). The monthly average of events changed significantly over the 3 years (2019 [477.7], 2020 [295.8], and 2021 [305.8]) (<em>P</em> &lt; .001). Additionally, there was a notable increase in the percentage of severe cases with red triage codes in 2020 (28.9%) and 2021 (33.5%) compared with 2019 (19.9%). Moreover, the number of hospitalized patients increased in 2020 (39.9%) and 2021 (37.2%) compared with 2019 (27.7%). The HEMS documented a noteworthy decrease in mission numbers and an increase in patient clinical severity during the pandemic. Consequently, the HEMS might be allocated for specific roles in national pandemic plans during the alert phase activation, such as secondary transport between hospital facilities.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 440-444"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239980","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":"Simulation-Based Learning to Assess and Improve Critical Care Transport Team Members’ Knowledge of Pediatric Intubation: A Quality Improvement Project","authors":"Andrea Campbell DNP, ARNP-CS, ACCNS-P, CCRN, C-NPT ,&nbsp;Judy Ascenzi DNP, RN ,&nbsp;Deborah W. Busch DNP, CRNP, CNE, FAANP, FAAN ,&nbsp;Christopher Baker MSN, MBA, RN, C-NPT","doi":"10.1016/j.amj.2024.06.003","DOIUrl":"10.1016/j.amj.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>The care of critically ill neonatal and pediatric patients requiring transport is optimized by using specialty transport teams. Research demonstrates that training is best accomplished through routine simulation. At the project site, no simulation-based learning is provided to critical care transport team members. This project aimed to implement a simulation-based learning program to improve the knowledge and self-competency of neonatal and pediatric critical care transport team members.</p></div><div><h3>Methods</h3><p>Team members participated in two 9-week paired pediatric simulations that incorporated intubation and mechanical ventilation. Testing was conducted through a knowledge test and self-competency survey completed before and after both simulations and a performance checklist for each simulation.</p></div><div><h3>Results</h3><p>There was a statistically significant increase in knowledge test scores from the baseline knowledge test to each subsequent test (<em>P</em> ≤ .001, <em>P</em> = .002, and <em>P</em> ≤ .001). For self-competency, there was a statistically significant increase from the first survey to the second (<em>P</em> ≤ 0.001) and fourth (<em>P</em> ≤ .001). From the first to the second simulation, there was a statistically significant increase in performance (<em>P</em> ≤ .001).</p></div><div><h3>Conclusion</h3><p>Paired simulation-based learning allows for the assessment and improvement of team members’ knowledge. Future research should focus on how this improved knowledge translates to patient care.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 421-426"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698363","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":"Editor's Note: Ways to Stay Ahead","authors":"David J. Dries MSE, MD","doi":"10.1016/j.amj.2024.07.006","DOIUrl":"10.1016/j.amj.2024.07.006","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Page 380"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239084","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}