Air Medical Journal最新文献_第7页

Flexible Fiber-Optic Scope Use in Retrieval Medicine: A Case Series 灵活的光纤镜在检索医学中的应用：病例系列

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.06.004

Thomas Brown BMBS , Oliver Cook MBBS , Clare Hayes-Bradley BSc, MBBS

{"title":"Flexible Fiber-Optic Scope Use in Retrieval Medicine: A Case Series","authors":"Thomas Brown BMBS , Oliver Cook MBBS , Clare Hayes-Bradley BSc, MBBS","doi":"10.1016/j.amj.2024.06.004","DOIUrl":"10.1016/j.amj.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>The use of flexible fiber-optic scopes is increasing across critical care specialities, but there is limited literature on their use in retrieval medicine. This study aims to describe a case series in which flexible fiber-optic scopes were used by New South Wales Ambulance Aeromedical Operations critical care teams.</p></div><div><h3>Methods</h3><p>A retrospective case series was performed in our service from January 1, 2019, to December 31, 2021. We searched our electronic medical retrieval database for the terms “aScope,” “Awake Fibreoptic Intubation (AFOI),” “Fibreoptic Intubation (FOI),” and “Nasal Endotracheal Tube (ETT)” to identify when a flexible fiber-optic scope was used.</p></div><div><h3>Results</h3><p>There were 16 uses of flexible fiber-optic scopes during the study period. The most common procedure was awake nasal fiber-optic intubation, which was performed during 9 cases, 7 of which were successful. Other procedures performed included 4 cases of intubation through a supraglottic airway, 1 case of an asleep fiber-optic intubation, 1 case of flexible nasoendoscopy for upper airway assessment, and 1 case of fiber-optic bronchoscopy via tracheostomy. These procedures were performed by anesthetic, emergency and intensive care doctors. This case series describes 4 of these cases in more detail.</p></div><div><h3>Conclusion</h3><p>This case series demonstrates a variety of procedural and diagnostic uses for flexible fiber-optic scopes in retrieval medicine. These procedures can have an important bearing on decision making and patient management. The training and clinical governance provided by our service in this skill appears to be safe and robust with high success rates of awake fiber-optic intubations.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 427-432"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699519","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

Psychomotor Vigilance Testing on Neonatal Transport: A Western Australian Experience 新生儿运输过程中的精神运动警觉性测试：西澳大利亚州的经验

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.05.003

{"title":"Psychomotor Vigilance Testing on Neonatal Transport: A Western Australian Experience","authors":"","doi":"10.1016/j.amj.2024.05.003","DOIUrl":"10.1016/j.amj.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to assess whether undertaking retrieval was associated with fatigue independent of sleep and circadian disruption. It also aimed to assess the feasibility of routinely measuring the psychomotor vigilance test (PVT) on neonatal transport. Fatigue is associated with impaired clinician performance and safety. The association between shift work, sleep deprivation, and circadian disruption is well established. No studies have specifically assessed the independent effect of the retrieval environment on fatigue.</p></div><div><h3>Methods</h3><p>Medical and nursing staff of the neonatal retrieval team were prospectively recruited over a 12-month period. Simple reaction times (RTs) were recorded at the start and end of a day shift using a validated 3-minute PVT.</p></div><div><h3>Results</h3><p>The end-of-shift RT increased (not significant) by 6.38 milliseconds (95% confidence interval [CI], −2.17 to 14.92 milliseconds; <em>P</em> = .149) when retrieval was undertaken. A 1-millisecond increase in RT increased the odds of being in a subjective sleepy category by 0.57% (95% CI, 0.0036-0.0078; <em>P</em> < .001). Consuming caffeine during the shift increased the mean RT by 16.26 milliseconds (95% CI, 4.43-28.1 milliseconds; <em>P</em> < .01).</p></div><div><h3>Conclusion</h3><p>The RT of participants exposed to the retrieval environment was not significantly increased. Further studies are needed to consolidate these results as well as to further assess longer-range air medical retrievals.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 401-405"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279260","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

Erratum to ‘Air Medical Transport of a 12-Year-Old Girl With Cerebral Gas Embolism Due to Helium Inhalation’ [Air Medical Journal 42/5 (2023) 377- 379] 对 "一名因吸入氦气导致脑气体栓塞的 12 岁女孩的空中医疗运送 "的勘误 [Air Medical Journal 42/5 (2023) 377- 379]

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.08.001

Emine M. Tunc MD , Richard B. Utarnachitt MD, MS , Andrew Latimer MD , Ashley Calhoun RN, BSN, CCRN, CFRN, EMT-B , Danielle Gamache RN, BSN, CFRN, CCRN, CEN, CPEN, EMT-B , Jessica Wall MD, MPH, MSCE, NRP

引用次数: 0

General Information 一般信息

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/S1067-991X(24)00175-5

引用次数: 0

Air Medical Transport of a 12-Year-Old Girl With Cerebral Gas Embolism Due to Helium Inhalation 空中医疗运送一名因吸入氦气而导致脑气体栓塞的 12 岁女孩

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.07.001

James R. Holm MD, FACP, FACEP, FUHM, Neil B. Hampson MD, FUHM

引用次数: 0

The Impact of the Coronavirus Disease 2019 Pandemic on Helicopter Emergency Medical Services 2019 年冠状病毒疾病大流行对直升机紧急医疗服务的影响

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.07.004

Roberta Pireddu , Francesca Bottega , Maria José De la Rosa , Serena Ruberti , Angelo Giupponi , Andrea Mina , Luca Filetici , Giovanni Cipolotti , Alberto Zoli , Carlo Signorelli

{"title":"The Impact of the Coronavirus Disease 2019 Pandemic on Helicopter Emergency Medical Services","authors":"Roberta Pireddu , Francesca Bottega , Maria José De la Rosa , Serena Ruberti , Angelo Giupponi , Andrea Mina , Luca Filetici , Giovanni Cipolotti , Alberto Zoli , Carlo Signorelli","doi":"10.1016/j.amj.2024.07.004","DOIUrl":"10.1016/j.amj.2024.07.004","url":null,"abstract":"<div><p>The coronavirus disease 2019 pandemic has profoundly affected the Lombardy healthcare system. Although air transport of critical patients played a crucial role, there are still gaps in understanding how the pandemic impacted helicopter emergency medical services (HEMS). A retrospective observational analysis was performed using data from the regional emergency-urgency online portal. The investigation focused on patients airlifted by helicopter to the Lombardy emergency departments from January 1, 2019, to December 31, 2021. A total of 12,953 admissions to the emergency departments have been recorded (5,733 in 2019, 3,550 in 2020, and 3,670 in 2021). The monthly average of events changed significantly over the 3 years (2019 [477.7], 2020 [295.8], and 2021 [305.8]) (<em>P</em> < .001). Additionally, there was a notable increase in the percentage of severe cases with red triage codes in 2020 (28.9%) and 2021 (33.5%) compared with 2019 (19.9%). Moreover, the number of hospitalized patients increased in 2020 (39.9%) and 2021 (37.2%) compared with 2019 (27.7%). The HEMS documented a noteworthy decrease in mission numbers and an increase in patient clinical severity during the pandemic. Consequently, the HEMS might be allocated for specific roles in national pandemic plans during the alert phase activation, such as secondary transport between hospital facilities.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 440-444"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239980","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

Simulation-Based Learning to Assess and Improve Critical Care Transport Team Members’ Knowledge of Pediatric Intubation: A Quality Improvement Project 通过模拟学习评估和改进重症监护转运团队成员的儿科插管知识：质量改进项目

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.06.003

Andrea Campbell DNP, ARNP-CS, ACCNS-P, CCRN, C-NPT , Judy Ascenzi DNP, RN , Deborah W. Busch DNP, CRNP, CNE, FAANP, FAAN , Christopher Baker MSN, MBA, RN, C-NPT

{"title":"Simulation-Based Learning to Assess and Improve Critical Care Transport Team Members’ Knowledge of Pediatric Intubation: A Quality Improvement Project","authors":"Andrea Campbell DNP, ARNP-CS, ACCNS-P, CCRN, C-NPT , Judy Ascenzi DNP, RN , Deborah W. Busch DNP, CRNP, CNE, FAANP, FAAN , Christopher Baker MSN, MBA, RN, C-NPT","doi":"10.1016/j.amj.2024.06.003","DOIUrl":"10.1016/j.amj.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>The care of critically ill neonatal and pediatric patients requiring transport is optimized by using specialty transport teams. Research demonstrates that training is best accomplished through routine simulation. At the project site, no simulation-based learning is provided to critical care transport team members. This project aimed to implement a simulation-based learning program to improve the knowledge and self-competency of neonatal and pediatric critical care transport team members.</p></div><div><h3>Methods</h3><p>Team members participated in two 9-week paired pediatric simulations that incorporated intubation and mechanical ventilation. Testing was conducted through a knowledge test and self-competency survey completed before and after both simulations and a performance checklist for each simulation.</p></div><div><h3>Results</h3><p>There was a statistically significant increase in knowledge test scores from the baseline knowledge test to each subsequent test (<em>P</em> ≤ .001, <em>P</em> = .002, and <em>P</em> ≤ .001). For self-competency, there was a statistically significant increase from the first survey to the second (<em>P</em> ≤ 0.001) and fourth (<em>P</em> ≤ .001). From the first to the second simulation, there was a statistically significant increase in performance (<em>P</em> ≤ .001).</p></div><div><h3>Conclusion</h3><p>Paired simulation-based learning allows for the assessment and improvement of team members’ knowledge. Future research should focus on how this improved knowledge translates to patient care.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 421-426"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698363","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

Editor's Note: Ways to Stay Ahead 编者按：保持领先的方法

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.07.006

David J. Dries MSE, MD

引用次数: 0

Proceedings: Sixth International Futures of Aviation Medicine Symposium 会议记录：第六届国际航空医学未来研讨会

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.07.005

Thomas Judge EMT-P , Jacqueline C. Stocking PhD, MBA, MSN, NEA-BC, FAASTN , Stephen H. Thomas MD, MPH

引用次数: 0

Peri-Intubation Push-Dose Vasopressors in Critical Care Transport 重症监护转运中的插管前推注式血管加压剂

Air Medical Journal Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.05.008

Alissa M. Bates MD , Alyson M. Esteves PharmD, BCPS, BCCCP , Kalle J. Fjeld MD , Ryan J. Ding BS , Jeremy M. Singleton RN, CFRN , Matthew A. Roginski MD, MPH

{"title":"Peri-Intubation Push-Dose Vasopressors in Critical Care Transport","authors":"Alissa M. Bates MD , Alyson M. Esteves PharmD, BCPS, BCCCP , Kalle J. Fjeld MD , Ryan J. Ding BS , Jeremy M. Singleton RN, CFRN , Matthew A. Roginski MD, MPH","doi":"10.1016/j.amj.2024.05.008","DOIUrl":"10.1016/j.amj.2024.05.008","url":null,"abstract":"<div><h3>Objective</h3><p>Push-dose vasopressors are commonly administered to attenuate peri-intubation hypotension. The aim of this study was to describe the current use of push-dose vasopressors in critical care transport.</p></div><div><h3>Methods</h3><p>This was a retrospective chart review of adult patients (≥ 18 years) intubated between January 2017 and May 2023 who received push-dose vasopressors. The outcomes were incidence of push-dose vasopressor administration and the frequency of initiation or an increase in continuous vasopressor infusion.</p></div><div><h3>Results</h3><p>Of the 334 patients intubated during this period, 49 (14.7%) received push-dose vasopressors in the peri-intubation period. The mean preintubation shock index was 1.1 ± 0.5. Of those who received push-dose vasopressors, 34 (69.4%) received multiple push doses; the mean number of administrations was 2.5 ± 1.9. Most patients had persistent or recurrent hypotension (n = 39, 79.6%). Fifteen (30.6%) were started on a continuous vasopressor infusion, and 3 (11.1%) had an increase in an existing infusion postintubation.</p></div><div><h3>Conclusion</h3><p>Although push-dose vasopressors are convenient and appropriate in many settings, they inadequately address hypotension in critically ill patients with underlying shock. Further investigation is required to better elucidate the role of peri-intubation push-dose and continuous vasopressors in the critical care transport setting.</p></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"43 5","pages":"Pages 412-415"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239842","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