Air Medical Journal最新文献_第6页

Air Transport Medicine: From the Field 航空运输医学：来自现场

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.09.008

Prof. Marius Rehn MD, PhD, Marit Bekkevold MD, Per Bredmose MD, PhD, Tone Solvik Olsen MD, Jostein Hagemo MD, PhD, James Price MB, BS, Ed B.G. Barnard PhD

引用次数: 0

Determining What Proportion of Helicopter Emergency Medical Services–Transported Patients Are Urban Versus Rurally Based: A Retrospective 36-Year Geospatial Analysis of a Critical Care Helicopter Emergency Medical Services Organization's Patient Transports 确定直升机紧急医疗服务运送的病人中城市与农村的比例：对一家危重护理直升机紧急医疗服务组织病人运送的36年回顾性地理空间分析

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.10.004

Domhnall O'Dochartaigh MSc , Elizabeth Schrekinger BSc , Glenda Farnden , Jon Gogan BPE (Kin) , Darren Hudson MD, FRCPC

{"title":"Determining What Proportion of Helicopter Emergency Medical Services–Transported Patients Are Urban Versus Rurally Based: A Retrospective 36-Year Geospatial Analysis of a Critical Care Helicopter Emergency Medical Services Organization's Patient Transports","authors":"Domhnall O'Dochartaigh MSc , Elizabeth Schrekinger BSc , Glenda Farnden , Jon Gogan BPE (Kin) , Darren Hudson MD, FRCPC","doi":"10.1016/j.amj.2024.10.004","DOIUrl":"10.1016/j.amj.2024.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>There is an increased mortality rate of patients residing in rural compared with urban communities. Helicopter emergency medical services (HEMS) decrease both the time to hospital arrival and trauma mortality in patients originating from rural areas. An unreported number of urban residents are served by HEMS. Our objective was to quantify the fraction of urban residents who live in the adjoining city of a HEMS base and are transferred by helicopter while they are in rural areas.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of HEMS charts between 1985 and 2022. Records were assessed for patients’ city and postal code. A secondary database was searched to assess mission location.</div></div><div><h3>Results</h3><div>Thirty-five thousand nine hundred seventy-one cases were analyzed; 3,871 (10.76%) cases involved patients residing within the urban area of an open HEMS base, and 32,100 (89.24%) did not. This contrasts with 2.04% of all missions conducted in urban areas. Cases flown with patients from outside of the 3 provinces were as follows: British Columbia (1,233/21,941; 5.3% of Alberta cases), international (988/35,971; 2.7% of total cases), Ontario (177/4,691; 3.6% of Manitoba cases), and other provinces combined (158/3,5971; 0.4% of total cases).</div></div><div><h3>Conclusion</h3><div>We highlight the impact of HEMS, where it serves both rural residents and all people who work in, travel through, visit, or recreate across the areas that our HEMS supports.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 575-577"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758899","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}

引用次数: 0

Evaluation of Isopropyl Alcohol Aromatherapy in Treating Nausea in Helicopter Emergency Medical Services Patients 异丙醇芳香疗法治疗直升机急诊病人恶心的疗效评价

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.08.004

David Koenig DO , Kevin P. Young FP-C , Robert Treat PhD , J. Marc Liu MD, MPH, FAEMS , Timothy Lenz MD, MPH, EMT-P, FAEMS, FACEP

{"title":"Evaluation of Isopropyl Alcohol Aromatherapy in Treating Nausea in Helicopter Emergency Medical Services Patients","authors":"David Koenig DO , Kevin P. Young FP-C , Robert Treat PhD , J. Marc Liu MD, MPH, FAEMS , Timothy Lenz MD, MPH, EMT-P, FAEMS, FACEP","doi":"10.1016/j.amj.2024.08.004","DOIUrl":"10.1016/j.amj.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>Isopropyl alcohol (IPA) aromatherapy provides rapid relief of nausea at minimal cost, is universally available, and has no known significant adverse effects. These attributes make it ideal for the prehospital setting. However, there is no published research on the use of IPA in critical care transport (CCT). The objective of this study was to investigate if CCT patients experience improvement of nausea with IPA aromatherapy.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed over a 2-year period on adult patients served by a Midwest CCT system that provides both air and ground transport. Data were obtained 1 year before and 1 year after a protocol change in which the first-line antiemetic was changed from intravenous ondansetron (prechange) to inhaled IPA (postchange). The IPA was administered by placing a pad under the patient's nares as they inhaled. The proportion of nausea improvement was compared between the prechange and postchange periods.</div></div><div><h3>Results</h3><div>Two hundred seventeen records were included. In helicopter emergency medical services, 33 of 50 (66.0%) patients reported improvement with ondansetron, and 13 of 21 (61.9%) reported improvement with IPA (<em>P</em> = .742). Patients transported by ground emergency medical services showed improvement in 65 of 73 (89.0%) cases for ondansetron and 40 of 73 (54.8%) for IPA (<em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>There was no difference in the proportion of nausea improvement between ondansetron and IPA in helicopter emergency medical services patients. In ground emergency medical services patients, more patients had nausea improvement with ondansetron compared with IPA. This study suggests IPA may be a faster, more efficacious alternative for nausea relief in CCT patients.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 518-522"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758913","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}

引用次数: 0

Italian Search and Rescue Seaplanes From the 50s to the 70s: A Brave People and Mighty Aircraft Story 从50年代到70年代的意大利搜救水上飞机：一个勇敢的人和强大的飞机的故事

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.09.007

Carlo Bellini MD, PhD

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Elevating Prehospital Traumatic Brain Injury Care: A Comparative Analysis of Civilian and Military Air Transport Guidelines 提高院前创伤性脑损伤护理：民用和军用航空运输指南的比较分析

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.10.002

Sarthak Parikh DO , Christopher G. Hendrix MD , Jeremy Norman BAS, FP-C, NRP , Andrew K. Kurklinsky MD

{"title":"Elevating Prehospital Traumatic Brain Injury Care: A Comparative Analysis of Civilian and Military Air Transport Guidelines","authors":"Sarthak Parikh DO , Christopher G. Hendrix MD , Jeremy Norman BAS, FP-C, NRP , Andrew K. Kurklinsky MD","doi":"10.1016/j.amj.2024.10.002","DOIUrl":"10.1016/j.amj.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic brain injuries (TBIs) are a leading cause of death and disability worldwide. Establishing TBI guidelines is crucial for prehospital management. Civilian medical practices are often influenced by military trauma guidelines. This study provides a comparative analysis of prehospital TBI management by a civilian air medical evacuation service using civilian guidelines and military clinical practice guidelines from the Joint Trauma System of the Department of Defense.</div></div><div><h3>Methods</h3><div>A retrospective review of 100 deidentified patient transport logs from a prominent civilian air medical service was conducted. The logs were compared with the service's patient care guidelines and the 2023 Joint Trauma System Clinical Practice Guidelines. Data were analyzed for adherence to 14 metrics.</div></div><div><h3>Results</h3><div>Patients showed improvement in preflight and postflight Glasgow Coma Scale scores and were managed according to recommendations on head elevation, oxygenation, blood pressure, and temperature by both organizations. Discrepancies between guidelines included differences in the management of ventilator settings, blood pressure, oxygenation, temperature, serum glucose, intracranial hypertension, suspected brain herniation, serum sodium levels, and seizure prophylaxis.</div></div><div><h3>Conclusion</h3><div>Comparing civilian and military guidelines highlights areas for potential improvements in TBI management, such as integrating advanced monitoring and the implementation of (i-STAT, Abbott Laboratories, Chicago, IL) testing in air transport to enhance patient care and outcomes.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 548-552"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758906","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}

引用次数: 0

November/December 2024 Forum 2024年11 / 12月论坛

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.09.011

引用次数: 0

Maternal Cardiac Arrest for Critical Care Transport Providers: A Review 重症监护转运提供者的产妇心脏骤停：综述

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.08.007

Charles Barrows DO, Michael J. Lauria MD, NRP, FP-C, Fatemeh Abbasi MD, Elizabeth Garchar MD, FACOG

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Acute Respiratory Distress Syndrome: Updates for Critical Care Transport 急性呼吸窘迫综合征：重症监护运输的最新进展

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.09.005

Matthew A. Roginski MD, MPH , Patricia Ruth A. Atchinson DO , Alyson M. Esteves PharmD, BCPS, BCCCP , Skyler A. Lentz MD , Kalle J. Fjeld MD , Jacob M. Markwood MD , Michael J. Lauria MD , Brittney Bernardoni MD

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UCAN Make a Difference: Over 40 Years of Flying High Above Chicago UCAN做出改变：在芝加哥上空飞行40多年

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.08.008

Meaghan J. Panfil MSN, RN, CFRN , Caitlin Kilcoyne BSN, RN, CFRN, C-NPT , Julianne Heiple MSN, APN, RN, FNP-C, CFRN , Ira J. Blumen MD, FACEP, FAMPA , Candice Schaper MSN, RN, CFRN, CCRN, CEN, PHRN , Michael P. McCartin MD

{"title":"UCAN Make a Difference: Over 40 Years of Flying High Above Chicago","authors":"Meaghan J. Panfil MSN, RN, CFRN , Caitlin Kilcoyne BSN, RN, CFRN, C-NPT , Julianne Heiple MSN, APN, RN, FNP-C, CFRN , Ira J. Blumen MD, FACEP, FAMPA , Candice Schaper MSN, RN, CFRN, CCRN, CEN, PHRN , Michael P. McCartin MD","doi":"10.1016/j.amj.2024.08.008","DOIUrl":"10.1016/j.amj.2024.08.008","url":null,"abstract":"<div><div>The University of Chicago Aeromedical Network (UCAN) was established in 1983 and has been providing critical care transport via both air and ground in and around the Chicago area for over 40 years. Over that time, the program has transported thousands of critically ill individuals, including complex specialty populations, while also maintaining a safe transport environment for its crew members and patients. UCAN has had a profound impact not only on its patients, but also on the entire transport community by providing continuing education, conducting vital safety research while maintaining the highest safety standards, and driving the industry forward through service and leadership. Since inception, the program has experienced many changes, including the transition from a traditional hospital-based program to an alternate delivery model and the conversion of the crew from a nurse-physician team to a nurse-nurse configuration. These changes have allowed for continuous evolution within UCAN, including the introduction of internal process improvements that focus on quality, safety and education, growth of the communications team and its capabilities, and expansion of UCAN's commitment to outreach and education for its community partners.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 488-492"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758895","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}

引用次数: 0

Sedation Management in the Intubated Pediatric Patient as a Method to Reduce Neuromuscular Blockade Utilization Rate During Transport: A Quality Improvement Project 镇静管理在插管儿童患者作为一种方法，以减少在运输过程中的神经肌肉阻滞使用率：一个质量改进项目

Air Medical Journal Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.07.008

Laura Lyons BSN, RN, CCRN, EMT-B , Jennifer Minehart MSN, RN , Christine Perebzak MSN, RN, CNS , Kerwyn Jones MD , Michael T. Bigham MD, MBA , Jeffrey Naples DO

{"title":"Sedation Management in the Intubated Pediatric Patient as a Method to Reduce Neuromuscular Blockade Utilization Rate During Transport: A Quality Improvement Project","authors":"Laura Lyons BSN, RN, CCRN, EMT-B , Jennifer Minehart MSN, RN , Christine Perebzak MSN, RN, CNS , Kerwyn Jones MD , Michael T. Bigham MD, MBA , Jeffrey Naples DO","doi":"10.1016/j.amj.2024.07.008","DOIUrl":"10.1016/j.amj.2024.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>Models recommending continuous sedation combined with specific tools to assess sedation depth during pediatric transport do not exist. Published studies demonstrate that nurse-driven sedation protocols yield more consistent levels of appropriate sedation.</div></div><div><h3>Methods</h3><div>A retrospective review in 2020 of mechanically ventilated pediatric transport patients at this institution demonstrated that 60.7% received neuromuscular blockade. This higher than anticipated neuromuscular blockade usage indicated an opportunity to improve sedation management. The primary aim of this quality improvement project is to decrease neuromuscular blockade use to < 30% of intubated pediatric patients cared for by our critical care transport team. To achieve this, we aimed to improve patient sedation by increasing the use of continuous sedation medication infusions to > 75% of patients by the first quarter of 2022. The initiative took place with a hospital-based pediatric/neonatal critical care transport team.</div></div><div><h3>Results</h3><div>Continuous sedation infusions increased using protocolized sedation from 10.7% at baseline to a sustained rate of 88% with dexmedetomidine (76.3%) and propofol (13.6%) as primary medications. The percentage of patients receiving neuromuscular blockade decreased in stepwise fashion from the initial 60.7% to 8.3%.</div></div><div><h3>Conclusion</h3><div>This project demonstrated sustained improvement in continuous sedation and decrease in neuromuscular blockade use through the initiation of a continuous sedation protocol in transport.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 493-498"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758896","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}

引用次数: 0