{"title":"Air Transport Medicine: From the Field—A Year in Review","authors":"James Price MBBS, Ed Barnard PhD","doi":"10.1016/j.amj.2024.12.007","DOIUrl":"10.1016/j.amj.2024.12.007","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 2","pages":"Pages 126-127"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706176","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}
Sebastian Harenberg PhD , Michelle C.E. McCarron PhD , Margaret Nieto MSc , Owen Scheirer MD , R. Nicholas Carleton PhD , Terence Ross MD
{"title":"Team Cohesion and Mental Disorder Symptoms in Canadian Helicopter Emergency Medical Service Personnel","authors":"Sebastian Harenberg PhD , Michelle C.E. McCarron PhD , Margaret Nieto MSc , Owen Scheirer MD , R. Nicholas Carleton PhD , Terence Ross MD","doi":"10.1016/j.amj.2025.01.004","DOIUrl":"10.1016/j.amj.2025.01.004","url":null,"abstract":"<div><div>Helicopter emergency medical service (HEMS) personnel are working in environments that may predispose them to stressful and traumatic events. However, the prevalence of posttraumatic stress and other mental health indicators in HEMS personnel is generally low. This study evaluated whether team cohesion may predict the prevalence of mental disorder symptoms. A total of 215 HEMS personnel from 6 Canadian provinces completed an online questionnaire measuring team cohesion and symptoms of posttraumatic stress and major depressive disorder. The results indicated that cohesion negatively predicted the prevalence of mental disorder symptoms. The findings imply that cohesion within teams is an important consideration in the management of mental health among HEMS personnel.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 2","pages":"Pages 161-163"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706329","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}
Kalle J. Fjeld MD , Alissa M. Bates MD , Matthew A. Roginski MD, MPH , Ryan J. Ding , Alyson M. Esteves PharmD, BCPS, BCCCP
{"title":"Evaluation of Reduced-Dose Induction Agents During Endotracheal Intubation in Critical Care Transport","authors":"Kalle J. Fjeld MD , Alissa M. Bates MD , Matthew A. Roginski MD, MPH , Ryan J. Ding , 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 <0.2 mg/kg or ketamine <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}
Tiffany S. Stone BS, BSN, RN, CPEN, CFRN , Cynthia L. Miller RN, MS, CFRN, NRP, CEN , Jonathan Summey BSRT, NRP, FP-C, RRT , Russ Bongiovanni RCP, RRT-ACCS , Erik Nemecek MSN, RN , Mark A. Merlin D.O. EMT-P, FACEP
{"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 , Cynthia L. Miller RN, MS, CFRN, NRP, CEN , Jonathan Summey BSRT, NRP, FP-C, RRT , Russ Bongiovanni RCP, RRT-ACCS , Erik Nemecek MSN, RN , 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":"<div><h3>Objective</h3><div>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?</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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":"Evolution of Helicopter Services and Their Development From a Medical Standpoint: Nepal","authors":"Sanij Singh MBBS, MDGP , Sagun Shrestha MBBS , Pritina Nakarmi MBBS , Rupesh Yadav MBBS , Suleyman Ulla MBBS , Sameep Singh MBBS , Rohendra Pande MBBS, MDGP , Praphul Kumar Jha MBBS, MDGP , Bimala Joshi MBA , Anish Baniya MBBS , Shruti Thapa BSc, MA , 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}
Michael J. Lauria MD, NRP, FP-C , Andrew Merelman MD , Jennifer L. Thompson MD , Darren A. Braude MD, MPH , A. Doran Bostwick MD
{"title":"Management of Critically Ill Patients With Pulmonary Arterial Hypertension in Transport: A Narrative Review","authors":"Michael J. Lauria MD, NRP, FP-C , Andrew Merelman MD , Jennifer L. Thompson MD , Darren A. Braude MD, MPH , 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}
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