Air Medical Journal最新文献

{"title":"Impact of Medical Evacuation From Mayotte to La Réunion on Intracranial Pressure in Pediatric Patients","authors":"Lukas Widmann MD,&nbsp;Yvonnick Boue MD,&nbsp;Vincent Gilles MD,&nbsp;Julien Carvelli MD,&nbsp;Perrine Venot MD","doi":"10.1016/j.amj.2026.02.014","DOIUrl":"10.1016/j.amj.2026.02.014","url":null,"abstract":"<div><h3>Objective</h3><div>Long-distance medical evacuation by ground, maritime, and fixed-wing air transport (EVASAN) from Mayotte to La Réunion is frequent for pediatric neurocritical patients. The impact of EVASAN on intracranial pressure (ICP) control is poorly documented, especially in this geographic and socioeconomic context. We aimed to analyze ICP variations during EVASAN and to describe associated physiological parameters and short-term outcomes.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of pediatric patients (&lt; 18 lt; 18 years) evacuated from Mayotte to La Réunion between January 2019 and December 2024 with invasive ICP monitoring at departure (n = 22). ICP values and clinical variables (mean arterial pressure [MAP], heart rate [HR], oxygen saturation [SpO₂], end-tidal carbon dioxide [EtCO₂], fraction of inspired oxygen [FiO₂], temperature, sedation, and vasopressor use) were extracted at predefined time points: initial (baseline), departure (intensive care unit), ferry transfer, takeoff, during flight, landing, and arrival at La Réunion pediatric intensive care unit. Primary outcome was ICP variation during EVASAN. Wilcoxon signed-rank tests compared paired time points; Spearman correlations explored associations. The study was approved under MR-004; consent was obtained as described.</div></div><div><h3>Results</h3><div>A total of 22 patients (mean age 9.4 years, 73% pediatric traumatic brain injury) were included. The ferry phase was associated with a modest but statistically significant median increase in ICP (+ 5 mm Hg, <em>P</em> = .038). No sustained increase between departure and arrival was observed (median + 3 mm Hg, <em>P</em> = .251). FiO₂ increased from a median of 0.3 to 0.4 (<em>P</em> = .008), whereas SpO₂, MAP, HR, and EtCO₂ remained stable. There was no correlation between ICP variation and 6-month Pediatric Glasgow Outcome Scale scores. Missing data and heterogeneity of care restricted inference.</div></div><div><h3>Conclusion</h3><div>In this single-center retrospective series, EVASAN was associated with transient ICP increases during the maritime ferry phase but not with sustained intracranial hypertension at arrival nor worse mid-term neurological outcome.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 385-394"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303412","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":"Beyond Lactate: Real-Time Resuscitation Targets for Septic Shock During Critical Care Transport","authors":"James L. Li MD, MEd, FAEMS,&nbsp;Aaron J. Lacy MD, MHPE, FACEP,&nbsp;Michael J. DeFilippo DO, FAAEM","doi":"10.1016/j.amj.2026.03.048","DOIUrl":"10.1016/j.amj.2026.03.048","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 312-315"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303348","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":"Forum July / August- Air Medical Journal (YMAM)","authors":"","doi":"10.1016/j.amj.2026.05.003","DOIUrl":"10.1016/j.amj.2026.05.003","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 343-344"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303356","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":"Self-Reporting Bias in Pediatric Prehospital Intubation","authors":"Karl-Christian Thies MD, FRCA, DEAA, FERC, FFRRHH, Ed","doi":"10.1016/j.amj.2026.03.053","DOIUrl":"10.1016/j.amj.2026.03.053","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Page 409"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302834","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":"Updates in Etomidate Versus Ketamine for Rapid Sequence Intubation of Critically Ill Patients","authors":"Katherine Stuart MD,&nbsp;James L. Li MD, MEd, FAEMS,&nbsp;Aaron J. Lacy MD, MHPE, FACEP","doi":"10.1016/j.amj.2026.03.052","DOIUrl":"10.1016/j.amj.2026.03.052","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 316-318"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302842","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":"Feasibility of Performing Rapid Sequence Intubation During Helicopter Flight in an AW169: A High-Fidelity Pilot Simulation Study","authors":"Allan M. McHenry,&nbsp;Joanne E. Griggs,&nbsp;Sophie Mitchinson,&nbsp;Kat Hunter,&nbsp;Richard Lyon,&nbsp;Air Ambulance Charity Kent Surrey Sussex","doi":"10.1016/j.amj.2026.04.002","DOIUrl":"10.1016/j.amj.2026.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>Rapid sequence intubation (RSI) in helicopter emergency medical services (HEMS) is conventionally performed at the scene before transport, potentially delaying time to definitive care. The feasibility of performing RSI during flight in civilian HEMS operations has not been established in the United Kingdom. We evaluate the feasibility, safety, and temporal efficiency of performing simulated in-flight RSI in an AW169 helicopter under operational flight conditions.</div></div><div><h3>Methods</h3><div>A prospective proof-of-concept study using high-fidelity simulation was conducted across 2 phases (May 2023, January 2025) at the Air Ambulance Charity Kent Surrey Sussex. Eight simulations were completed by 4 distinct clinical teams comprising operationally experienced HEMS physicians and paramedics. Scenarios replicated a standardized traumatic brain injury scenario requiring RSI during the return transit phase. The primary outcome was time from RSI checklist initiation to confirmed intubation. Secondary outcomes included overall mission times, safety events, and crew-perceived feasibility assessed via post-scenario questionnaires.</div></div><div><h3>Results</h3><div>All simulations (8/8, 100%) achieved successful first-pass intubation. Median time from checklist initiation to confirmed intubation was 5 minutes (interquartile range [IQR]: 5-7). Median total mission time from base departure to RSI completion was 42 minutes (IQR 40-44). No safety events, procedural complications, or communication failures occurred. Crew questionnaires (93% response rate) confirmed unanimous perceived feasibility, with participants identifying adequate workspace, effective communication, and manageable equipment accessibility.</div></div><div><h3>Conclusion</h3><div>High-fidelity simulation demonstrates that in-flight RSI is technically feasible in an AW169 helicopter, with consistent procedural times and no safety events. These findings may support further evaluation of in-flight RSI as a complementary strategy for time-critical patients where scene-based airway management may delay definitive care.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 363-369"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303346","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":"Consensus on Neonatal and Pediatric Interfacility Transport","authors":"Corina Noje MD,&nbsp;Ranna Rozenfeld MD,&nbsp;Robert G. Holcomb MD,&nbsp;Michele Moss MD,&nbsp;Franscesca Miquel Verges MD,&nbsp;Scott Saunders MD, PhD,&nbsp;Tammy Rush MSN, C-NPT,&nbsp;Jan Eichel MBARN,&nbsp;Don Null MD,&nbsp;Richard Zimmerman RRT-NSP, C-NPT,&nbsp;Lisa Pruitt BSN, C-NPT,&nbsp;Emily Krennerich MD,&nbsp;Matthew Harris MD,&nbsp;Rudy Kink MD,&nbsp;Webra Price Douglas CRNP, PhD,&nbsp;Hamilton Schwartz MD,&nbsp;Michael H. Stroud MD","doi":"10.1016/j.amj.2026.02.004","DOIUrl":"10.1016/j.amj.2026.02.004","url":null,"abstract":"<div><div>The practice of neonatal/pediatric transport medicine continues to advance. Teams have evolved from providing critical care outside tertiary care centers to participating in collaborative research efforts, benchmarking and quality improvement, developing innovative partnerships, and pushing the limits of care provision during interfacility transport. The most recent consensus document on neonatal and pediatric transport medicine was published more than a decade ago. Advancements in the field necessitate the dissemination of new practices in transport medicine. The following manuscript details the current evidence-supported, expert consensus opinions on the practice of neonatal and pediatric transport medicine and recommendations for its future direction.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 414-420"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303317","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":"From Wooden Mock-Ups to Hybrid Ecosystems: A Systems Architecture Approach to Next-Generation Helicopter emergency medical services/Search and Rescue Crew Training","authors":"Jose Manuel Gutierrez-Rubio MD","doi":"10.1016/j.amj.2026.04.008","DOIUrl":"10.1016/j.amj.2026.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>Helicopter emergency medical services (HEMS) and search and rescue operations represent the intersection of aviation complexity and clinical criticality. Despite technological advances in simulation, most training programs remain fragmented across aviation and medical domains, failing to integrate the human factors that determine mission success. This program report describes the longitudinal development of an integrated HEMS simulation training system, from early low-fidelity cabin prototypes to contemporary multi-sensory and hybrid simulation environments, and proposes a systems architecture framework applicable to next-generation air medical crew training.</div></div><div><h3>Methods</h3><div>We describe the staged development of a longitudinal HEMS simulation training initiative in multiple years, evaluate relevant regulatory and competency-based training frameworks, review international centers of excellence, and synthesize lessons learned into an architectural proposal for integrated air medical training systems.</div></div><div><h3>Results</h3><div>Early multi-sensory simulation incorporating cabin noise, smoke, temperature changes, and communication systems demonstrated that clinical performance degrades significantly under operational stress—a finding now validated by evidence-based training frameworks. The September 2024 European Union Aviation Safety Agency regulatory update removing Full Flight Simulator mandates for helicopters, combined with virtual and mixed reality qualification milestones, creates unprecedented opportunity for hybrid training architectures.</div></div><div><h3>Conclusion</h3><div>HEMS training requires systems thinking—not isolated course development. Organizations designing next-generation programs need professionals who can integrate competency frameworks, immersive technologies, behavioral assessment tools, and clinical-operational training into unified ecosystems. This report provides an architectural blueprint applicable to HEMS, search and rescue, and critical care transport.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 345-353"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303371","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":"Strategies to Optimize Skill Acquisition and Prevent Skill Decay for the Air Transport Clinician","authors":"McKayley Green BA, EMT,&nbsp;Aaron J. Lacy MD, MHPE, FACEP,&nbsp;James L. Li MD, MEd, FAEMS,&nbsp;John E. Schneider MD, MEHP","doi":"10.1016/j.amj.2026.04.007","DOIUrl":"10.1016/j.amj.2026.04.007","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 319-321"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302824","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":"Blood On Board Project: Experience From Pegaso 2 Base in Grosseto, 4.5 Years After Implementation","authors":"Jacopo Frizzi MD,&nbsp;Michela Ciminello MD,&nbsp;Alessandra Roggi MD,&nbsp;Luca Berti MD,&nbsp;Giovanni Sbrana MD,&nbsp;Sara Montemerani MD,&nbsp;Chiara Barneschi MD,&nbsp;Vanni Pastorelli BSN,&nbsp;Stefano Barbadori MD","doi":"10.1016/j.amj.2026.02.001","DOIUrl":"10.1016/j.amj.2026.02.001","url":null,"abstract":"<div><div>This brief communication is intended to share with all colleagues working in helicopter emergency medical services and prehospital emergency care the methods for managing blood components and transfusions with O-negative packed red blood cells (PRBCs) in our operational setting. The “Blood on Board” project was initiated in our Unit 4 and a half years ago, and the number of patients transfused with O-negative PRBCs has progressively increased, demonstrating the efficacy and safety of the procedure.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 4","pages":"Pages 410-413"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303373","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}