Air Medical Journal最新文献

{"title":"Outcomes After Interhospital Critical Care Transfer","authors":"Meghan E. Edmondson PhD, RN, CCRN ,&nbsp;Andrew P. Reimer PhD, RN, CFRN","doi":"10.1016/j.amj.2024.05.005","DOIUrl":"10.1016/j.amj.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><p>Patients who undergo interhospital transfer, particularly for intensive care unit (ICU) care, experience greater length of stay and mortality. There is evidence that patients transferred for surgical ICU care experience higher mortality rates; however, differences in length of stay or mortality across other ICU types remain unclear. The goals of this work were to assess how length of stay and mortality differ by ICU subspecialties.</p></div><div><h3>Methods</h3><p>We conducted a retrospective analysis of an existing critical care transfer data repository. We used multiple and logistic regression to identify significant factors that contribute to differences in length of stay and mortality for surgical ICU patients.</p></div><div><h3>Results</h3><p>There were no differences in length of stay or mortality based on ICU subspecialty. For every 1-year increase in age, mortality odds increased by 8.6% (<em>P</em> = .002). Patients transferred from an ICU had a longer length of stay by 6.3 days (<em>P</em> &lt; .001). Non-Caucasian patients had a shorter length of stay by 3.4 days (<em>P</em> = .012).</p></div><div><h3>Conclusion</h3><p>Length of stay and mortality are not influenced by ICU subspecialty. Further research is needed to determine the mechanism by which sending unit type and race influence length of stay and identify other factors that predict mortality for SICU patients.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 406-411"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1067991X24000907/pdfft?md5=4cf8da2cde50d4795db9cf9dc21269f3&pid=1-s2.0-S1067991X24000907-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239840","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":"Critical Elements of Medical Protocols","authors":"Eileen Frazer RN, CMTE,&nbsp;Jan Eichel MBA, RN, CFRN, FAASTN,&nbsp;Tobin Miller DNP, MSN/Ed., RN, CEN, CCRN, CFRN","doi":"10.1016/j.amj.2024.06.008","DOIUrl":"10.1016/j.amj.2024.06.008","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 376-377"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239082","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 Transport Medicine: From the Field","authors":"James Arthur MBBS,&nbsp;Jonathan Berger MBChB, ES,&nbsp;Jack Lewis MBBS,&nbsp;Andrew Patton MBBCh, BAO,&nbsp;Jacob Tant MEmergHlth,&nbsp;Brian Burns MBBCh, BAO, MSc,&nbsp;James Price MBBS,&nbsp;Ed B.G. Barnard PhD","doi":"10.1016/j.amj.2024.07.003","DOIUrl":"10.1016/j.amj.2024.07.003","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 378-379"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239083","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":"Patients With Near Arrest Induced by Foreign Body Airway Obstructions Treated by a Physician-Staffed Helicopter","authors":"Youichi Yanagawa MD, PhD,&nbsp;Hiroaki Taniguchi MD,&nbsp;Kenji Kawai MD,&nbsp;Hiroki Nagasawa MD, PhD","doi":"10.1016/j.amj.2024.07.002","DOIUrl":"10.1016/j.amj.2024.07.002","url":null,"abstract":"<div><p><span>Acute airway obstruction<span><span>, whether partial or complete, requires immediate intervention to prevent fatal outcomes. An 81-year-old man with a history of pneumonia experienced respiratory distress after attempting to swallow a large piece of meat. Despite attempts by his daughter, back blows and abdominal thrusts failed to dislodge the obstruction, and he collapsed, prompting an emergency call. Upon the arrival of the </span>emergency medical team, the patient was conscious with good </span></span>oxygen saturation<span> but deteriorated during transport, becoming unresponsive and unable to cough. Upon assessment by the doctor helicopter team, the patient's condition was critical with low oxygen saturation and unstable vital signs. Using a laryngoscope, the team identified a large meat fragment near the vocal cords<span><span> and successfully removed it, relieving the obstruction. The patient's respiratory distress improved, and he was transported to the hospital without the need for intubation. Further examination at the hospital revealed </span>sinus tachycardia<span> and lung abnormalities on a computed tomography scan but no significant abnormalities in blood tests. The patient was admitted for observation and received antibiotics for prophylaxis. He recovered well, with no further need for oxygen by the second day and was discharged on the fourth day, highlighting the importance of prompt intervention in airway emergencies.</span></span></span></p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 454-456"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691058","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":"Flying Doctor Services in Sarawak: A Medical Frontline Experience","authors":"Lim Siong Hee MD ,&nbsp;Sam Froze Giee MD ,&nbsp;Winnie Johnny MD ,&nbsp;Lai Hui Yee MD","doi":"10.1016/j.amj.2024.05.001","DOIUrl":"10.1016/j.amj.2024.05.001","url":null,"abstract":"<div><p>Malaysia has a 34.3 million population, with 40% residing in rural areas. Since gaining independence, the Malaysian government put a tremendous focus as well as resources in improving the health care services with the aim of improving the health status of Malaysians. The Ministry of Health is the main stakeholder in ensuring quality of services, accessibility, and equity in providing health care to the community. Unfortunately, some rural areas in the state of Sarawak are beyond reachable via land or water transportation. Hence, a flying doctor service was introduced in the state of Sarawak in 1973 for this purpose. However, the quality of care is still limited because of various reasons and challenges faced. Nevertheless, efforts in improving the health care status of the rural continue as we aim to leave no one behind.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 392-394"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239841","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":"Pericardiocentesis During Transport for Cardiac Tamponade Complicating Acute Type A Aortic Dissection","authors":"","doi":"10.1016/j.amj.2024.04.001","DOIUrl":"10.1016/j.amj.2024.04.001","url":null,"abstract":"<div><p><span><span>The use of bedside ultrasound imaging<span> has become a valuable tool in emergency medicine, and its use in the transport environment is increasing. Survival Flight, the critical care transportation program at University of Michigan/Michigan Medicine, began to train flight nurses in its use beginning in 2014. Nurses were trained during mandatory training sessions, with different skills and interpretations gradually added. Nurses who have been trained in procedures such as </span></span>pericardiocentesis are empowered to use that training to perform procedures via online or, if necessary, offline medical direction. The Butterfly IQ+ devices are currently utilized. Pericardiocentesis can be a lifesaving procedure for </span>pericardial tamponade<span>. However, its use in relieving tamponade caused by thoracic aortic dissection remains controversial due to the possibility of worsening the dissection with restoration of more normal blood pressure. We report 2 cases of in-transport, ultrasound-guided pericardiocentesis for 2 patients with tamponade caused by type A aortic dissection and discuss its use in this clinical situation.</span></p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 445-449"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395745","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":"September/October 2024 Forum","authors":"","doi":"10.1016/j.amj.2024.07.007","DOIUrl":"10.1016/j.amj.2024.07.007","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 390-391"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239091","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":"Comparison of Interfacility Transfer of Critically Ill Pediatric Patients by Helicopter Versus Ground Ambulance in a Remote and Rural Domain","authors":"Sivanath Peeracheir MD ,&nbsp;Kanjanee Wachirarangsiman MD ,&nbsp;Terence Martin MBBS, DAvMed, DRTM, FCRS, FRCA","doi":"10.1016/j.amj.2024.06.005","DOIUrl":"10.1016/j.amj.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><p>Since 2018, Thailand's helicopter emergency medical service (HEMS) has been used to transport critically ill pediatric patients from Tak Province's community hospitals to the tertiary care hospital. This article describes a pilot study to look at the feasibility of comparing mortality rates and complications during transport.</p></div><div><h3>Methods</h3><p>This retrospective pilot study used data from the medical records of the referring and receiving hospitals. Participants were critically ill patients under 18 years of age who were transferred between facilities using HEMS or ground emergency medical services (GEMS) between January 2018 and December 2022. HEMS transported 9 patients, whereas GEMS transported 52.</p></div><div><h3>Results</h3><p>The predominant age group was newborns. Respiratory-related conditions were the most common diagnoses. The majority of patients underwent intubation and displayed abnormal respiratory rates and levels of consciousness before flight. Approximately one third were hypotensive or required vasoactive drugs. Cardiac arrest requiring cardiopulmonary resuscitation was the most common significant complication during transport in the HEMS group (22.2%). Meanwhile, changing hospital destination because of an unstable patient condition was the most common complication during transport in the GEMS group (3.9%). Hypotension was the most common complication upon arrival at the receiving hospital in both groups (25% versus 8%). HEMS demonstrated shorter transport times.</p></div><div><h3>Conclusion</h3><p>HEMS reduced transport times compared with GEMS. However, there was a higher incidence of cardiac arrest requiring cardiopulmonary resuscitation during transfer and hypotension upon arrival.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 433-439"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1067991X2400124X/pdfft?md5=26f156e382ede92f1e2a5ad3b9067e1a&pid=1-s2.0-S1067991X2400124X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689601","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":"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}