Air Medical Journal最新文献

{"title":"March-April 2026 Forum","authors":"","doi":"10.1016/j.amj.2026.01.014","DOIUrl":"10.1016/j.amj.2026.01.014","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 101-102"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147410709","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":"Patterns of Injuries in Danish Motorcyclists Requiring Air Ambulance Activation: A 5-Year Review","authors":"Ka Jun Cheng MBBS ,&nbsp;Carsten Meilandt MSc ,&nbsp;Leif Rognås PhD, MD","doi":"10.1016/j.amj.2025.11.002","DOIUrl":"10.1016/j.amj.2025.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>Powered 2-wheeler (PTW) riders are a highly vulnerable road-user group who frequently require helicopter emergency medical services (HEMS) for critical care and transport. This study aimed to describe the population of injured PTW riders attended by the Danish Air Ambulance and compare them with the wider Danish HEMS trauma population.</div></div><div><h3>Methods</h3><div>This was a retrospective population-based study of Danish HEMS missions from January 1, 2018, to December 31, 2023, including all primary missions involving a PTW patient. Data were collected from the Danish HEMS database on patient demographics, vehicle type, interventions performed, and destination. We also registered International Classification of Diseases, 10th edition, diagnoses and National Advisory Committee for Aeronautics (NACA) scores.</div></div><div><h3>Results</h3><div>A total of 228 patients (90% male) were included. The most common diagnosis was unspecified multiple injuries (49%), indicating polytrauma. Significant differences were noted between vehicle types: 58% of injured motorcyclists were involved in accidents with another vehicle, whereas 59% of scooter rider incidents were single vehicle. Notably, 67% of PTW patients were assigned a NACA score of ≥4, and 71% required at least 1 prehospital intervention. Most were transported to a major trauma center (MTC) (85% of motorcyclists vs. 76% of scooter riders). Compared with the general Danish HEMS trauma population, PTW patients had higher NACA scores, were more likely to be conveyed to MTCs, and more frequently required prehospital interventions.</div></div><div><h3>Conclusion</h3><div>PTW riders attended to by the Danish Air Ambulance represent a severely injured patient cohort who more frequently require advanced prehospital treatment and transport than the wider trauma population.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 126-132"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272358","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 Training to Promote Whole Blood Administration Protocol Among Critical Care Transport of Trauma Patients","authors":"Olivia C. Newbern DNP, CRNA ,&nbsp;Julee Waldrop DNP, FNP, PNP, CNE, EBP-C ,&nbsp;Michele Kuszajewski DNP, RN, CHSE ,&nbsp;Virginia C. Simmons DNP, CRNA, CHSE-A, ANEF, FAANA, FAAN","doi":"10.1016/j.amj.2025.10.013","DOIUrl":"10.1016/j.amj.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>Trauma patients often present to emergency departments with coagulopathies. Recognizing the unique challenges of caring for trauma patients and the urgent need for protocol-driven resuscitation is essential.</div></div><div><h3>Methods</h3><div>This project used a practice evaluation design that incorporated simulation-based learning (SBL) to educate critical care transport team (CCTT) providers on the existing whole blood administration protocol (WBAP), aiming to enhance protocol adherence and staff preparedness.</div></div><div><h3>Results</h3><div>Most participants (77%) successfully adhered to all critical decision points, indicating notable improvements in adherence. Participants reported increased confidence, knowledge, and preparedness following SBL, each with a mean of 2.9 and a median of 3.0, where 1 = do not agree, 2 = somewhat agree, and 3 = strongly agree. Simulation reinforced critical decision-making (mean 3.0) and procedural skills (mean 2.9), aligning with established best practices.</div></div><div><h3>Conclusion</h3><div>SBL improved trauma care training, reinforced critical decision-making, and strengthened procedural skills among CCTT providers. Further research is needed to assess multiple aspects of the WBAP during critical care transport missions and the long-term sustainability of educational interventions. Ongoing training, policy enhancements, and continued whole blood use in CCTT care may contribute to improved outcomes for trauma patients.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 121-125"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272279","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":"Benjamin Miller MD,&nbsp;Jay Zhang MD,&nbsp;Christian Martin-Gill MD, MPH,&nbsp;Frank Guyette MD, MPH,&nbsp;Dylan Morris MD,&nbsp;Leonard Weiss MD,&nbsp;James Price MBBS,&nbsp;Ed B.G. Barnard PhD","doi":"10.1016/j.amj.2025.12.002","DOIUrl":"10.1016/j.amj.2025.12.002","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 93-95"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272319","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":"General Information","authors":"","doi":"10.1016/S1067-991X(26)00040-4","DOIUrl":"10.1016/S1067-991X(26)00040-4","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Page 92"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147410712","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":"Postintubation Hemodynamic Collapse in Traumatically Injured Critical Care Transport Patients: A Retrospective Cohort Study","authors":"Kalle J. Fjeld MD ,&nbsp;Jacob M. Markwood MD ,&nbsp;Abby L. Blake DO ,&nbsp;Alissa M. Bates MD ,&nbsp;Alyson M. Esteves PharmD, BCPS, BCCCP ,&nbsp;Matthew A. Roginski MD, MPH","doi":"10.1016/j.amj.2025.10.007","DOIUrl":"10.1016/j.amj.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal intubation of trauma patients incurs risks including post-intubation hemodynamic collapse. Trauma patients are at increased risk of secondary harm related to hypotension. The aim of this study was to describe post-intubation hemodynamic collapse in traumatically injured CCT patients and investigate associations with in-hospital outcomes.</div></div><div><h3>Methods</h3><div>Retrospective chart review of trauma patients ≥18 years admitted to a rural level one trauma center who were transported and intubated by the hospital-based CCT service between January 2017 and June 2024. Hemodynamic collapse was defined as cardiac arrest, systolic blood pressure (SBP) &lt;65 mmHg at least once, SBP &lt;90 mmHg for greater than 30 minutes, new vasopressor requirement, vasopressor dose increase, or fluid bolus of &gt;15 mL/kg to maintain SBP. The primary outcome was the incidence of hemodynamic collapse. Secondary outcomes were identification of potentially modifiable patient risk factors and in-hospital outcomes including length of stay and mortality.</div></div><div><h3>Results</h3><div>One hundred forty-two trauma patients were included. Thirty-five (24.6%) patients experienced hemodynamic collapse and 2 (5.7%) had cardiac arrest. When controlled for ISS, patients with pre-intubation blood administration (OR 5.89, 95% CI 1.8-19.31), pre-intubation vasopressors (OR 11.21, CI 2.02-62.25), and first systolic blood pressure &lt;90 mmHg (OR 7.66, CI 1.18-49.74) had higher odds of hemodynamic collapse after intubation. The median shock index and injury severity scores (ISS) were also higher: 1.07 (0.71-1.38) versus 0.68 (0.53-0.84) and 36 (14-43) versus 24 (17-34), respectively (<em>p</em> &lt;0.05). When controlled for ISS there was no significant difference in hospital mortality (OR 1.78, 95% CI 0.73-4.36).</div></div><div><h3>Conclusion</h3><div>Post-intubation hemodynamic collapse occurred in 1 in 4 patients in this cohort of traumatically injured patients. Patients with post-intubation hemodynamic collapse were more likely to have received blood, fluids, and vasopressors and they had higher ISS and in-hospital mortality. The risks and benefits of a definitive airway for these patients must be carefully weighed.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 111-116"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272344","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":"A Simulation-Based, Qualitative Assessment of Decision Making Among Critical Care Transport Crews","authors":"Daniel Johnson DO ,&nbsp;Heather Costigan MPH ,&nbsp;Candace Bordner MS ,&nbsp;Avram Flamm DO ,&nbsp;Lauren Van Scoy MD","doi":"10.1016/j.amj.2025.10.010","DOIUrl":"10.1016/j.amj.2025.10.010","url":null,"abstract":"<div><h3>Objective</h3><div>The breadth and complexity of care in the out-of-hospital environment are increasing. The clinical decision-making process of emergency medical services clinicians is not well understood.</div></div><div><h3>Methods</h3><div>This study aimed to analyze the process of critical care transport clinicians using simulated scenarios with structured debriefing. Members of a critical care transport team completed a simulation session during which they cared for a medical or trauma patient with airway management concerns. A standardized debriefing exploring their decision-making process was performed after the simulation session, recorded, and transcribed. Thematic analysis was performed to uncover themes related to the clinical decision making that took place.</div></div><div><h3>Results</h3><div>A total of 8 subjects (5 nurses and 3 paramedics) completed simulation sessions including 5 medical and 3 trauma scenarios. The median years of experience in critical care transport was 15. The following 3 themes emerged from the quantitative analysis: (1) participants felt that the scenarios were realistic and applicable to their daily practice, (2) participants felt that the scenarios required them to think critically, and (3) participants relied on established protocols combined with experience for their clinical decision making.</div></div><div><h3>Conclusion</h3><div>During the simulated care of complex patients with airway management concerns, critical care transport clinicians made complex decisions by using a combination of standing protocols, experience, and foundational knowledge.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 117-120"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272337","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 Prehospital Blood Transfusion in Helicopter Emergency Medical Services and Survival: A Retrospective Population-Based Cohort Study","authors":"Naoya Miura MD, MPH, PhD,&nbsp;Asuka Tsuchiya MD, MPH, PhD,&nbsp;Motohiro Matsumoto MD,&nbsp;Hiromichi Aoki MD,&nbsp;Seiji Morita MD, PhD","doi":"10.1016/j.amj.2025.11.003","DOIUrl":"10.1016/j.amj.2025.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>Critical hemorrhage is a life-threatening condition in which blood transfusion is an essential lifesaving intervention. Although the importance of prehospital blood transfusion is increasingly recognized, its effectiveness remains unclear, particularly in Asian health care settings. This study aimed to characterize patients receiving prehospital blood transfusion through helicopter emergency medical services (HEMS) and evaluate their association with survival outcomes in a Japanese population-based cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective evaluation of data from the Japanese Society for Aeromedical Services Registry from April 2020 to March 2023. This study included adult patients transported by physician-staffed HEMS. Propensity score matching (1:4) was used to adjust for confounding factors. The primary outcome measure was patient survival until hospital discharge.</div></div><div><h3>Results</h3><div>Among the 24,776 patients, 71 (0.3%) received prehospital blood transfusions using type O packed red blood cells. Transfusion recipients had lower systolic blood pressures (83 mm Hg vs. 138 mm Hg; <em>P</em> &lt; .001) and higher rates of external causes of injury (80.3% vs. 51.1%; <em>P</em> &lt; .001) than did those who did not receive a transfusion. After propensity score matching (<em>N</em> = 230), prehospital transfusion was associated with improved survival (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.05–4.18). The results of the trauma subgroup analysis showed no statistically significant association (OR, 1.88; 95% CI, 0.80–4.40).</div></div><div><h3>Conclusion</h3><div>In Japan’s physician-staffed HEMS, prehospital blood transfusion was appropriately provided to patients with hemorrhagic shock and, after adjustment for confounding factors, was associated with improved survival. These findings provide evidence supporting the potential benefits of prehospital blood transfusion in appropriately selected patients within physician-staffed air medical systems.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 133-139"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272329","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":"Interhospital Transport Characteristics for Neonates With Congenital Diaphragmatic Hernia","authors":"Katrin C. Lichtsinn MD, MS ,&nbsp;Daniel A. Enquobahrie MD, MPH, PhD ,&nbsp;John Feltner MS ,&nbsp;Aditya Goparaju ,&nbsp;Megan M. Gray MD ,&nbsp;Sandy Johng MD ,&nbsp;Mihai Puia-Dumitrescu MD, MPH ,&nbsp;Rebecca Stark MD ,&nbsp;Rachel Umoren MBBCh, MS ,&nbsp;Zeenia C. Billimoria MD","doi":"10.1016/j.amj.2025.12.001","DOIUrl":"10.1016/j.amj.2025.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Congenital diaphragmatic hernia (CDH) occurs when a diaphragmatic defect develops in utero, allowing herniation of the abdominal contents into the chest cavity. As a result, many neonates with CDH are critically ill after birth owing to varying degrees of pulmonary hypoplasia, respiratory failure, pulmonary hypertension, and cardiac dysfunction. Neonates with CDH require surgical repair of the diaphragmatic defect, and those who are not born at a center with the ability to perform pediatric surgery must be transferred to one shortly after birth. Our objective was to describe transport characteristics and vital sign variability for neonates with CDH transferred after delivery.</div></div><div><h3>Methods</h3><div>This was a retrospective observational analysis of 51 neonates with prenatally diagnosed CDH born at a single delivery hospital between March 2020 and March 2024 and transported to a single tertiary referral neonatal intensive care unit. Descriptive statistics were used to compare groups by CDH severity.</div></div><div><h3>Results</h3><div>Neonates with severe CDH were transported more rapidly than those with mild or moderate CDH. During transport, more neonates with severe disease received inhaled nitric oxide, but other transport interventions were not significantly different between the groups. All neonates experienced at least 1 abnormal vital sign. A higher proportion of neonates with severe CDH had low oxygen saturation values compared with those with milder disease.</div></div><div><h3>Conclusion</h3><div>Vital sign abnormalities were universally common during transport, highlighting the physiologic instability of neonates with CDH. Understanding these transport variables will aid provider teams in decision making for these critically ill neonates.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 140-146"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272292","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":"Definitive Airway Management in the Critical Care Transport Medicine Environment: An Exploratory Convenience Survey-Based Analysis of Retrieval Experts on the Profound Shock State Patient","authors":"Craig Tschautscher MD, MS ,&nbsp;Christopher Stephens MD ,&nbsp;Steven Bott MD ,&nbsp;Lesley Osborn MD ,&nbsp;Ina Schmidt MD ,&nbsp;Jason Cohen DO ,&nbsp;Benjamin Lawner DO, MS, EMT-P ,&nbsp;Adam L. Gottula MD","doi":"10.1016/j.amj.2025.10.003","DOIUrl":"10.1016/j.amj.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Airway management in profoundly unstable patients, particularly those in a peri-arrest state, remains a contentious issue in out-of-hospital environments. Although there is robust literature on advanced airway procedures for acutely ill patients, literature on prehospital patients in profound shock is sparse. This study represents a survey-based analysis of critical care transport medicine (CCTM) experts to describe the challenges and strategies for intubating patients with significant hemodynamic instability.</div></div><div><h3>Methods</h3><div>Before the Air Medical Physician Symposium (AMPS) Lite, an online exploratory survey was developed from a convenience sample of AMPS attendees regarding best practices, knowledge gaps, barriers to translation, and research priorities. AMPS featured educational lectures and discussions on critical care transport topics, including definitive airway management for patients in profound shock. Participants included CCTM experts from a variety of programs across the United States and internationally. The symposium included expert panel discussions and audience ranking of these categories using electronic voting.</div></div><div><h3>Results</h3><div>The survey-based analysis highlighted the importance of understanding the physiological and pharmacological principles surrounding rapid sequence intubation and other intubation strategies. Rankings emphasized the need for research on shock dosing of sedatives and the potential for paralytic-only intubation in profoundly obtunded patients.</div></div><div><h3>Conclusion</h3><div>The study concluded that further investigation is needed to develop evidence-based guidelines for intubating patients in profound shock. The findings suggest that reduced sedation dosing and consideration of using paralytic-only intubation may mitigate the risks of cardiovascular collapse and improve patient outcomes in this critically ill patient population.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 2","pages":"Pages 105-110"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272281","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}