Air Medical Journal最新文献

英文中文

Boosting Confidence Through Interagency Air Medical Simulation: A Quality Assurance Exercise of a Critical Care Helicopter Landing at a Tertiary Trauma Hospital 通过机构间空中医疗模拟增强信心：三级创伤医院重症监护直升机降落的质量保证演习

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.09.003

John Iliff FACEM , Breeanna Spring MMedHlthScRes , San Kumaradevan MCom , David Cosford FACEM , Jenny Vance FACEM , Alice Richardson BA(Hons), MStats, PhD , Fergus Gardiner OAM, PhD

Objective

Emergency preparedness training in health care improves patient outcomes. For critically unwell patients outside the hospital setting, air medical helicopter hospital landings expedite emergency health care access. However, little is known of interagency staff experiences during this multifaceted health care provision. We captured staff experiences during the first interagency air medical helicopter landing simulation exercise between the Royal Flying Doctor Service of Australia and Royal Perth Hospital in Western Australia as a quality assurance exercise.

Methods

The simulation exercise yielded 21 participants (hospital and air medical clinicians, logisticians, and pilots) and 8 simulation facilitators who consented to provide data between June and October 2023. Data were collected by phone interviews and surveys and analyzed descriptively and qualitatively.

Results

Facilitators reported that conducting successful interagency helicopter retrieval simulations requires extensive planning and preparation. After the simulation, participants reported increased clinical confidence in their specific role, with a desire for greater exposure to diverse simulation training to optimize their future performances for real scenarios. Simulation debriefs allow for further participant clarification surrounding the overall process. They provide a medium for valuable feedback to health service providers in process refinement in the management of the critically unwell, enhancing a culture of safety.

Conclusion

This study highlighted that interagency simulations are a valuable exercise when multiple health service providers are involved in the management of individual patients who are critically unwell. The significant effort to organize and coordinate to create high-fidelity scenarios by facilitators is rewarded with significant benefit found by the participants in their ability to be prepared for the real-life scenario. Such findings have important implications for ongoing interagency collaboration and ongoing health care and educational strategy.

目的：卫生保健应急准备培训可改善患者预后。对于医院外的严重不适患者，空中医疗直升机医院着陆加快了紧急医疗服务的准入。然而，在这种多方面的卫生保健提供过程中，对机构间工作人员的经验知之甚少。在澳大利亚皇家飞行医生服务处和西澳大利亚皇家珀斯医院之间的第一次机构间空中医疗直升机着陆模拟演习中，我们收集了工作人员的经验，作为质量保证演习。模拟演习共有21名参与者（医院和航空医疗临床医生、后勤人员和飞行员）和8名模拟协调员，他们同意在2023年6月至10月期间提供数据。通过电话访谈和调查收集数据，并进行描述性和定性分析。协调员报告说，成功进行机构间直升机检索模拟需要广泛的计划和准备。在模拟之后，参与者报告了他们对自己特定角色的临床信心增加，并希望更多地接触各种模拟训练，以优化他们未来在真实场景中的表现。模拟汇报允许参与者进一步澄清整个过程。它们提供了一种媒介，向保健服务提供者提供宝贵的反馈，以改进严重不适的管理过程，加强安全文化。结论：本研究强调，当多个卫生服务提供者参与对个体严重不适患者的管理时，机构间模拟是一项有价值的练习。引导者为组织和协调创造高保真情景所付出的巨大努力得到了回报，参与者发现他们为现实场景做好准备的能力得到了显著的好处。这些发现对正在进行的机构间合作以及正在进行的保健和教育战略具有重要意义。

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引用次数: 0

January-February 2026 Forum 2026年1 - 2月论坛

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.11.005

引用次数: 0

Effects of Transport Team Composition on Neonatal Intubation Success 转运队伍组成对新生儿插管成功率的影响

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.09.005

Alyssa J. Averhoff DO , Junghyae Lee PhD , Robyn Sawyer RN , Emily Mohs APRN-NP , Cori Kerr APRN-NP , Courtney McLean MD, MS

Objective

Neonatal transport is necessary to move the smallest and sickest patients. Transport team configuration can vary among institutions. One major concern with varied team composition is the ability to intubate neonates. This study investigates team composition effects on neonatal intubation success when performed by a neonatal nurse practitioner (NNP) or critical care transport (CCT) registered nurses (RNs) and paramedics.

Methods

Neonates <4 weeks of age who were intubated on transport between 2016 and 2023 were analyzed by retrospective chart review. Intubation success and number of attempts were compared between NNP and CCT, while controlling for confounding factors such as birth weight, age, and use of premedication or video laryngoscope.

Results

A total of 111 neonates were included in the study with 119 intubation procedures by transport team members. There was no difference in the overall intubation success rate between the NNP and CCT with an average of 84% (P = .68). An increase in first-attempt success rate with the CCT was found, which was not significant after controlling for the use of premedication and video laryngoscope.

Conclusion

During the study period, neonatal intubation success on transport did not differ when comparing NNP with CCT. This result supports staffing neonatal transport teams based on staffing availability.

目的对最小和病情最轻的患儿进行产前转运是必要的。运输团队的配置可能因机构而异。不同团队组成的一个主要问题是给新生儿插管的能力。本研究探讨了新生儿执业护士（NNP）或重症监护转运（CCT）注册护士（RNs）和护理人员对新生儿插管成功率的影响。方法回顾性分析2016 ~ 2023年4周龄转运中插管新生儿的资料。比较NNP和CCT的插管成功率和尝试次数，同时控制混杂因素，如出生体重、年龄、用药前或视频喉镜的使用。结果本研究共纳入111例新生儿，由转运组人员进行119次插管操作。NNP和CCT的总插管成功率无差异，平均为84% （P = 0.68）。CCT的首次尝试成功率有所增加，但在控制前用药和视频喉镜的使用后，这种增加并不显著。结论在研究期间，NNP与CCT比较，新生儿转运插管成功率无显著差异。这一结果支持基于人员可用性的新生儿运输团队的人员配置。

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引用次数: 0

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

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.10.012

Jason Cohen DO, FACEP, FCCM, FAEMS , Vahé Ender FP-C, C-NPT , Michael A. Frakes APRN, EMTP, FCCM, FACHE , Susan R. Wilcox MD, FCCM, FAAEM , James Price MBBS , Ed B.G. Barnard PhD

引用次数: 0

One Mission, One Team: Celebrating 40 Years of Duke Life Flight 同一个任务，同一个团队：庆祝杜克大学生命飞行40周年

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.05.007

Anna Sapp RN, BSN, CCRN, C-NPT

Background

Duke LifeFlight, established in 1985, has provided four decades of exceptional critical care transport to patients across the Southeast. As one of the first hospital-based air medical programs in North Carolina, it has set the standard for safety, innovation, and clinical excellence.

Objective

To commemorate the 40-year anniversary, celebrated last year, of Duke LifeFlight by highlighting its historical milestones, evolving capabilities, and lasting impact on patient outcomes and prehospital care.

Methods/Approach

A retrospective review of archival data, program development timelines, and patient care advancements. Key performance indicators and patient transport volumes were analyzed to illustrate growth and effectiveness.

Results

Since inception, Duke LifeFlight has completed thousands of transports, expanded to include rotor- and fixed-wing aircraft capabilities as well as critical care ground teams, and maintained accreditation from the Commission on Accreditation of Medical Transport Systems (CAMTS). Innovations in training, telemedicine, and trauma care have further elevated its regional and national standing.

Conclusion

Over 40 years, Duke LifeFlight has exemplified resilience, clinical excellence, and leadership in critical care transport. As it enters a new era, the program remains dedicated to advancing prehospital medicine and continuing its mission of delivering lifesaving care when seconds matter most.

duke LifeFlight成立于1985年，为东南部地区的患者提供了40年的特殊重症监护运输服务。作为北卡罗莱纳州第一个以医院为基础的空中医疗项目之一，它为安全、创新和临床卓越设定了标准。目的通过强调杜克生命飞行的历史里程碑、不断发展的能力以及对患者预后和院前护理的持久影响，纪念去年庆祝的杜克生命飞行40周年。方法/方法回顾性回顾档案资料、项目开发时间表和患者护理进展。分析了关键绩效指标和患者运输量，以说明增长和有效性。自成立以来，杜克生命飞行已经完成了数千次运输，扩展到包括旋翼和固定翼飞机能力以及重症护理地面团队，并保持了医疗运输系统认证委员会（CAMTS）的认证。培训、远程医疗和创伤护理方面的创新进一步提高了其在区域和国家的地位。结论40多年来，杜克生命飞行在重症监护运输方面展现了韧性、临床卓越和领导地位。当它进入一个新的时代，该计划仍然致力于推进院前医学，并继续其使命，在最重要的时刻提供救生护理。

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引用次数: 0

General Information 一般信息

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/S1067-991X(25)00360-8

引用次数: 0

Air Embolism After Diving and Decisions Surrounding Air Transport 潜水后的空气栓塞和围绕航空运输的决策

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.10.002

Mary Kraby RN, CFRN, CCRN, Michael Dunn FP-C, Andrea Tsai MD, Michael Frakes APRN, NRP, Jason Cohen DO, Susan R. Wilcox MD

A healthy young woman sustained severe hyperbaric injury after scuba diving, despite having done previous dives. She had an asystolic cardiac arrest immediately after ascent and was resuscitated for 90 minutes before return of spontaneous circulation (ROSC). After ROSC, she remained profoundly unstable, on multiple vasopressors, with refractory hypothermia and hypoxemia. She was diagnosed with arterial gas emboli (AGE) leading to arrest. The only treatment for AGE is rapid hyperbaric oxygen therapy, but she was too acute to be cared for in any local hyperbaric chamber. The closest chamber that could accommodate a patient of her acuity was 440 miles away. The critical care transport team was prepared to transport her, but such a transport created numerous clinical and logistical challenges.

一名健康的年轻女子在潜水后遭受了严重的高压伤，尽管她以前潜水过。她在上升后立即出现心脏骤停，并在恢复自然循环（ROSC）前复苏90分钟。在ROSC后，她仍然非常不稳定，使用多种血管加压药物，伴有难治性低体温和低氧血症。她被诊断为动脉气体栓塞（AGE）导致心脏骤停。AGE的唯一治疗方法是快速高压氧治疗，但她的病情过于严重，无法在任何局部高压氧室进行治疗。能容纳她这种视力的病人的最近的房间在440英里之外。重症监护转运小组准备运送她，但这样的转运带来了许多临床和后勤方面的挑战。

引用次数: 0

Facilitators and Barriers Influencing Resilience Amongst Critical Care Transport Professionals in a Fixed-Wing Air Ambulance Environment 影响固定翼空中救护环境中重症监护运输专业人员恢复力的因素和障碍

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.09.001

Karien Basson RN, MCur (DCur candidate) , Isabel Coetzee-Prinsloo RN, PGCHE, MCur, Dlitt et Phil, FANSA , Annatjie van der Wath RN, BCur, MCur, DCur , Letitia Greenberg BA, Ba (Hons)

Objective

This study describes the facilitators and barriers influencing resilience in a fixed-wing air ambulance environment.

Methods

Self-reported interview guides were used to explore and describe the facilitators and barriers influencing resilience among critical care transport professionals in a fixed-wing air ambulance environment.

Results

The findings revealed 12 facilitators and 8 barriers influencing resilience among critical care transport professionals in a fixed-wing air ambulance environment in South Africa.

Conclusion

The findings revealed 12 facilitators and eight barriers influencing resilience among CCTPs in the fixed-wing air ambulance environment in South Africa.

目的研究固定翼空中救护环境中影响心理弹性的因素和障碍。方法采用自报告访谈指南，探讨和描述固定翼空中救护环境中影响重症监护运输专业人员心理韧性的因素和障碍。结果研究结果揭示了南非固定翼空中救护环境中影响重症监护运输专业人员恢复力的12个促进因素和8个障碍。结论在南非固定翼空中救护环境中，影响cctp恢复力的因素有12个，障碍有8个。

引用次数: 0

Air Medical and Transport Simulation Training of Critically Ill Cases With Radioactive Contamination in Nuclear Power Stations by Japanese Helicopter Emergency Medical Services 日本直升机紧急医疗服务对核电站放射性污染危重病人的空中医疗和运输模拟训练

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.08.010

Shinsuke Tanizaki MD , Hiroyuki Azuma MD , Hisamasa Ishii MD , Naoto Okabe , Tatsuro Yoshinaga , Kenji Nakaya , Taketsune Kobuchi MD , Tetsuya Kimura MD , Shigenobu Maeda MD

Objective

Helicopter emergency medical service (HEMS) personnel require specialized training and continuous skill development tailored to their unique operational demands. These demands may include managing critically ill patients with radioactive contamination within radiologically controlled areas to ensure the delivery of high-quality care and safety. A unified consensus was archived after several discussions among relevant agencies, incorporating the safety of flight personnel of the helicopter-operating company and HEMS medical staff. Standardized procedures were developed. To our knowledge, no simulation-based training program for HEMS crew currently exists that specifically addresses the management of critically ill patients with radioactive contamination in such environments. This report aims to assess the validity of the training scenario based on newly established procedures throughout participant’s self-reported questionnaires.

Methods

An air medical and transport simulation training was conducted for life-threatening illnesses involving radioactive contamination at nuclear power stations. Participants completed self-reported evaluations using a 5-point Likert scale to assess the training.

Results

The specialized simulation scenario involved a patient with subarachnoid hemorrhage and suspected localized external contamination. The median scores for scenario-related scores were 1, indicating the highest levels of agreement, whereas the median scores for overall training and post-training feedback were 2, also demonstrating relatively high levels of agreement.

Conclusion

In our experience, simulation training scenarios involving critically ill patients with radioactive contamination in nuclear facilities enhance the competencies of both flight personnel and HEMS medical staff. These scenarios also support smoother implementation of HEMS responses to incidents within nuclear facilities and provide a basis for ongoing refinement and improvement of operational procedures.

目的直升机紧急医疗服务（HEMS）人员需要根据其独特的操作需求进行专门培训和持续的技能发展。这些要求可能包括在放射控制区内管理受放射性污染的危重病人，以确保提供高质量的护理和安全。直升机运营公司飞行人员的安全与HEMS医护人员的安全，经过相关部门的多次讨论，形成了统一的共识。制定了标准化程序。据我们所知，目前还没有针对急救人员的模拟培训计划，专门针对在这种环境中放射性污染的危重病人的管理。本报告旨在评估基于参与者自我报告问卷新建立程序的培训方案的有效性。方法开展核电站放射性污染危及生命疾病的空中医疗和运输模拟培训。参与者使用5分李克特量表完成自我报告评估来评估培训。结果专门的模拟场景涉及1例蛛网膜下腔出血患者，怀疑局部外部污染。场景相关得分的中位数为1，表明一致性的最高水平，而总体训练和训练后反馈的中位数得分为2，也表明了相对较高的一致性水平。结论根据我们的经验，核设施放射性污染危重病人的模拟训练场景可以提高飞行人员和HEMS医务人员的能力。这些情景还支持在核设施内更顺利地实施HEMS响应，并为持续改进和改进操作程序提供基础。

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引用次数: 0

Use of Health Care Simulation in Air Medical Settings: A Scoping Review 在空气医疗环境中使用卫生保健模拟：范围审查

Q3 Nursing

Air Medical Journal

Pub Date : 2026-01-01 DOI: 10.1016/j.amj.2025.10.004

William B. Belk MSc , Marybeth Wiedemann MSc , Paul O’Connor PhD , Roisin O’Malley PhD

Objective

Simulation-based training is well suited to unique and high-risk settings such as air medicine. Given that the use of simulation to educate air medical professionals continues to grow, there is a need to understand how simulation-based training methods have been used in air medicine thus far. This scoping review aimed to explore the use of simulation as a training method for air medical professionals.

Methods

The current review was conducted according to the 5-step process established by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Five electronic databases were searched, alongside gray literature and reference list screening. Studies that used simulation-based methods to train air medical professionals were included.

Results

Of the 21 included studies, most programs used scenario-based simulation (65.0%), multimodal simulation (30.0%), or simulated participants (5.0%). Simulation programs typically involved native teams and targeted team development (50.0%) or focused on contextualized clinical skill building with partial teams (40.0%), whereas a single study focused on hands-on instruction of foundational clinical skills (5.0%) and observed and debriefed teams in the clinical setting (5.0%). The most common form of assessment was of reactions to the simulation program (55.0%), followed by changes in learning (45.0%), behavior (5.0%), and organizational impact (5.0%).

Conclusion

Research is required to identify the unique needs of the air medical setting and develop effective and feasible methods to address learning outcomes, the impact of which must be evaluated. Simulation should be embedded into air medical training programs, and educators should be supported with the resources, materials, and learning facilities needed to develop effective simulation programs.

目的以模拟为基础的训练非常适合于特殊和高风险的环境，如空气医学。鉴于利用模拟技术对航空医疗专业人员进行教育的情况不断增加，有必要了解迄今为止在航空医学中如何使用基于模拟的培训方法。这一范围审查的目的是探讨将模拟作为空中医疗专业人员的一种培训方法。方法本综述按照Arksey和O 'Malley建立的5步流程和系统评价的首选报告项目和范围评价的元分析扩展进行。检索了5个电子数据库，以及灰色文献和参考文献列表筛选。包括使用基于模拟的方法培训航空医疗专业人员的研究。在21项纳入的研究中，大多数项目使用基于场景的模拟（65.0%）、多模式模拟（30.0%）或模拟参与者（5.0%）。模拟项目通常涉及本地团队和目标团队发展（50.0%），或者侧重于局部团队的情境化临床技能建设（40.0%），而单一研究侧重于基础临床技能的实践指导（5.0%），并在临床环境中观察和报告团队（5.0%）。最常见的评估形式是对模拟程序的反应（55.0%），其次是学习变化（45.0%），行为变化（5.0%）和组织影响（5.0%）。结论需要进行研究，以确定空中医疗环境的独特需求，并制定有效可行的方法来解决学习结果，必须评估其影响。模拟应该嵌入到空中医疗培训计划中，教育工作者应该得到开发有效模拟计划所需的资源、材料和学习设施的支持。

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