Jeong Hyeok Lee PhD , Ki Hong Kim MD , Ki Jeong Hong MD, PhD , Yong Joo Park MD , Kyoung Jun Song MD, PhD , Sang Do Shin MD, PhD
{"title":"Epidemiology and Expected Cost of International Medical Repatriation Into South Korea: 2019 to 2021","authors":"Jeong Hyeok Lee PhD , Ki Hong Kim MD , Ki Jeong Hong MD, PhD , Yong Joo Park MD , Kyoung Jun Song MD, PhD , Sang Do Shin MD, PhD","doi":"10.1016/j.amj.2024.10.005","DOIUrl":"10.1016/j.amj.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Overseas Koreans face challenges in accessing adequate medical care abroad. Understanding the epidemiology and costs of international medical repatriation is important.</div></div><div><h3>Methods</h3><div>A retrospective analysis of overseas Korean patients who were repatriated to South Korea between 2019 and 2021 was conducted. The data collected from 121 countries included demographics, medical conditions, and costs. Variables from 9 continents (Southeast Asia, Northeast Asia, Southwest Asia–Pacific, Russia–Central Asia, North America, Central and South America, Europe, Middle East‒North Africa, and Sub-Saharan Africa) and the era of coronavirus disease 2019 (February 2020 and after) were analyzed and compared. Based on the available total cost data, stepwise extrapolation was conducted for the total cohort.</div></div><div><h3>Results</h3><div>A total of 428 overseas Korean patients who had undergone international medical repatriation via air transport were included in this study. The greatest number of repatriated patients were from Southeast Asia (108 patients), and 279 patients were transported within the coronavirus disease 2019 era. The average cost per patient exceeded $7,000, and the total cost estimated by extrapolation was over $8 million.</div></div><div><h3>Conclusion</h3><div>International medical repatriation is significant for overseas Koreans. Standardized guidelines and system development are essential for effective air medical services.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 6","pages":"Pages 553-558"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758907","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":"Recent Outcomes Research in Helicopter Emergency Medical Services: A Scoping Review of Publication Year 2023 Additions to the Helicopter Outcomes Assessment Research Database","authors":"","doi":"10.1016/j.amj.2024.05.002","DOIUrl":"10.1016/j.amj.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this scoping review was to identify and characterize helicopter emergency medical services (HEMS) outcomes literature from 2023, with the goal of describing updates to the Critical Care Transport Collaborative Outcomes Research Effort HEMS Outcomes Assessment Research Database (HOARD).</p></div><div><h3>Methods</h3><p>Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, a multireviewer approach was used to source and review articles published or in preprint databases from 2023. The articles included assessed a patient-centered outcome for HEMS versus a non-HEMS control group. Article characteristics included the journal impact factor (JIF), diagnostic group (trauma or nontrauma), and geographic origin. Categoric analyses comparing 2023 studies with HOARD studies from the previous decade (2013-2022) were executed with the Fisher exact test; nonnormal JIF data were described using median and interquartile range and analyzed (vs 2013-2022) with rank sum testing.</p></div><div><h3>Results</h3><p>Of the initial records (N = 4,486), 4,410 were screened out, leaving 76 for full-text review. Of these, 58 were discarded, and 18 were classified as eligible for addition to HOARD. Most studies (14/18, 78%) focused on trauma, and an equally high proportion (14/18, 78%) came from North America. The median JIF was 2.4 (interquartile range, 1.2-3.6). Compared with HOARD studies from the previous decade, 2023 studies were similar with respect to diagnostic focus (<em>P</em> = .779), geographic origin (<em>P</em> = .171), and JIF (<em>P</em> = .531).</p></div><div><h3>Conclusion</h3><p>This scoping review provides information on 18 HEMS outcomes studies new to the evidence base in 2023.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 395-400"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401320","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}
Rebecca K. Bell MD , Skyler A. Lentz MD , Jeremy C. Patten NRP , Patricia Ruth A. Atchinson DO , Matthew A. Roginski MD, MPH
{"title":"Airway and Ventilator Management in a New Presentation of Idiopathic Subglottic Stenosis: A Case Report","authors":"Rebecca K. Bell MD , Skyler A. Lentz MD , Jeremy C. Patten NRP , Patricia Ruth A. Atchinson DO , Matthew A. Roginski MD, MPH","doi":"10.1016/j.amj.2024.06.002","DOIUrl":"10.1016/j.amj.2024.06.002","url":null,"abstract":"<div><p><span>In the acute setting, subglottic stenosis<span> poses a unique airway management challenge, particularly when presenting to a facility where subspecialty care is not available. We present a case of idiopathic subglottic stenosis with acute respiratory distress managed at a community hospital to highlight the challenges of diagnosis, initial airway management, and </span></span>mechanical ventilation of this rare but life-threatening condition.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 450-453"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239837","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}
Meghan E. Edmondson PhD, RN, CCRN , Andrew P. Reimer PhD, RN, CFRN
{"title":"Outcomes After Interhospital Critical Care Transfer","authors":"Meghan E. Edmondson PhD, RN, CCRN , 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> < .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}
Eileen Frazer RN, CMTE, Jan Eichel MBA, RN, CFRN, FAASTN, Tobin Miller DNP, MSN/Ed., RN, CEN, CCRN, CFRN
{"title":"Critical Elements of Medical Protocols","authors":"Eileen Frazer RN, CMTE, Jan Eichel MBA, RN, CFRN, FAASTN, 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}
James Arthur MBBS, Jonathan Berger MBChB, ES, Jack Lewis MBBS, Andrew Patton MBBCh, BAO, Jacob Tant MEmergHlth, Brian Burns MBBCh, BAO, MSc, James Price MBBS, Ed B.G. Barnard PhD
{"title":"Air Transport Medicine: From the Field","authors":"James Arthur MBBS, Jonathan Berger MBChB, ES, Jack Lewis MBBS, Andrew Patton MBBCh, BAO, Jacob Tant MEmergHlth, Brian Burns MBBCh, BAO, MSc, James Price MBBS, 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, Hiroaki Taniguchi MD, Kenji Kawai MD, 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}
Lim Siong Hee MD , Sam Froze Giee MD , Winnie Johnny MD , Lai Hui Yee MD
{"title":"Flying Doctor Services in Sarawak: A Medical Frontline Experience","authors":"Lim Siong Hee MD , Sam Froze Giee MD , Winnie Johnny MD , 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}