Air Medical Journal最新文献

英文中文

General Information 一般信息

Q3 Nursing

Air Medical Journal

Pub Date : 2025-10-27 DOI: 10.1016/S1067-991X(25)00288-3

引用次数: 0

Analysis of Helicopter Emergency Medical Services Metrics-Altmetrics Score Perspective: HEMS-MAP 直升机紧急医疗服务指标分析-另类指标评分视角：HEMS-MAP

Q3 Nursing

Air Medical Journal

Pub Date : 2025-10-27 DOI: 10.1016/j.amj.2025.07.008

Murat Çetin MD , Derşan Onur MD , Başak Bayram MD , Sercan Bıçakçı MD , Mustafa Emin Çanakçı MD , Melih İmamoğlu MD , Çağlar Kuas MD , Sergey Motov MD , Brit Long MD , Michael Gottlieb MD

Objective

Helicopter emergency medical services (HEMS) provide time-sensitive transport and advanced prehospital care. Although traditional bibliometrics (eg, citation counts) have measured academic impact, the role of alternative metrics (altmetrics), such as social media and news mentions, in capturing real-time scholarly influence remains underexplored in HEMS research. To evaluate the relationship between traditional citation metrics and altmetric indicators in HEMS-related publications and to identify trends in online engagement and academic dissemination.

Methods

This cross-sectional analysis included 817 HEMS-related articles published between 1984 and 2025, identified using Altmetric Explorer. Data were extracted from Altmetric Explorer, PlumX Metrics, and Springer Nature Citations, covering various traditional and alternative impact indicators. Descriptive statistics summarized citation and altmetric indicators. Spearman’s correlation analysis assessed relationships between Altmetric Attention Score (AAS), Mendeley readership, and citation counts from multiple sources (Dimensions, CrossRef, Scopus, PubMed). Geographic and temporal engagement patterns were also evaluated.

Results

The mean AAS was 11.18 ± 28.80, and the mean citation count (Dimensions) was 17.04 ± 24.48. A strong positive correlation was found between AAS and X (formerly Twitter) mentions (ρ = 0.723, P < .001). Mendeley readers had strong positive correlations with citation counts. However, overall correlations between AAS and citation counts were weak. Social media engagement was highest in the United Kingdom and the United States. Nordic countries dominated policy and guideline citations.

Conclusion

This is the first comprehensive altmetric analysis of HEMS-related publications. Although AAS reflects online attention, it correlates only modestly with traditional academic impact. Altmetrics offer complementary insight into research dissemination, especially in the digital age, and may inform more holistic evaluation strategies in prehospital and emergency medicine scholarship.

目的直升机紧急医疗服务（HEMS）提供时间敏感的运输和先进的院前护理。虽然传统的文献计量学（如引用计数）已经测量了学术影响，但替代计量学（altmetrics），如社交媒体和新闻提及，在获取实时学术影响方面的作用在HEMS研究中仍未得到充分探索。评估hems相关出版物中传统引文指标与替代指标之间的关系，并确定在线参与和学术传播的趋势。方法采用Altmetric Explorer对1984年至2025年间发表的817篇与hems相关的文章进行横断面分析。数据摘自Altmetric Explorer、PlumX Metrics和施普林格Nature citation，涵盖了各种传统和替代影响指标。描述性统计总结了引文和替代指标。Spearman的相关分析评估了Altmetric Attention Score （AAS）、Mendeley reader和来自多个来源的引用数之间的关系（Dimensions, CrossRef, Scopus, PubMed）。地理和时间参与模式也进行了评估。结果平均原子吸收光谱（AAS）为11.18±28.80，平均被引数（Dimensions）为17.04±24.48。在AAS和X（以前的Twitter）提及之间发现了很强的正相关（ρ = 0.723, P < .001）。Mendeley读者与引用次数有很强的正相关。然而，AAS与引文数量之间的总体相关性较弱。英国和美国的社交媒体参与度最高。北欧国家主导了政策和指南的引用。结论本文首次对hems相关文献进行了全面的替代分析法分析。尽管AAS反映了在线关注，但它与传统学术影响的相关性并不大。Altmetrics为研究传播提供了补充见解，特别是在数字时代，并可能为院前和急诊医学奖学金提供更全面的评估策略。

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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 : 2025-10-03 DOI: 10.1016/j.amj.2025.08.007

Joanne Griggs MSc, Jack Barrett PhD, Scott Clarke MBChB, Richard Lyon MBChB, James Price MBBS, Ed Barnard PhD

引用次数: 0

The Erosion and Evolution of Medical Peer-Review Privilege: A 2025 Perspective for Air Medical and Critical Care Transport 医学同行评议特权的侵蚀和演变：2025年航空医疗和重症监护运输的前景

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-25 DOI: 10.1016/j.amj.2025.08.008

John R. Clark JD, MBA, NRP, FP-C, CCP-C, WP-C, CMTE

引用次数: 0

November-December 2025 Forum 2025年11 - 12月论坛

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-25 DOI: 10.1016/j.amj.2025.09.006

引用次数: 0

Vasodilatory Shock—From Initial Resuscitation to Rescue Therapies: Narrative Review and Considerations for Critical Care Transport 血管扩张性休克-从最初的复苏到抢救治疗：叙述回顾和对重症监护运输的考虑

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-20 DOI: 10.1016/j.amj.2025.08.009

Brittney Bernardoni MD , Mikko Sayre MD , Matthew Roginski MD, MPH , Adam L. Gottula MD , Alyson Esteves PharmD , Craig Tschautscher MD, MS , Michael Lauria MD

Vasodilatory shock is a critical condition marked by maldistribution of blood flow leading to decreased oxygen delivery and organ dysfunction. Although sepsis is the most well-studied cause, other causes include anaphylaxis, endocrine or neurologic dysfunction, toxidromes, and the post-cardiac arrest or post-cardiopulmonary bypass state. After appropriate volume resuscitation, vasopressors may be added in a stepwise manner targeting a mean arterial pressure of >65 mm Hg to ensure organ perfusion. If a patient does not respond adequately to these initial measures, a “resuscitation checkpoint” can be used as a debiasing strategy to consider other contributing factors to shock. If cardiac dysfunction is present, consider addition of inotropes. Metabolic resuscitation may be accomplished in appropriate patients with corticosteroids, calcium, or sodium bicarbonate. Finally, emerging treatments may be considered for refractory vasodilatory shock, including angiotensin II, methylene blue, and hydroxocobalamin. Overall, this review presents an evidence-based tiered approach to management of refractory vasodilatory shock in critical care transport.

血管扩张性休克是一种以血流分布不均匀导致供氧减少和器官功能障碍为特征的危重症。虽然败血症是研究最充分的原因，但其他原因包括过敏反应、内分泌或神经功能障碍、毒体病、心脏骤停或体外循环后状态。在适当的容量复苏后，可逐步添加血管加压药，目标为平均动脉压65mmhg，以确保器官灌注。如果患者对这些初始措施没有充分的反应，“复苏检查点”可以作为一种消除偏见的策略，以考虑其他导致休克的因素。如果有心功能不全，考虑加用抗肌力药物。适当的患者可以使用皮质类固醇、钙或碳酸氢钠来完成代谢复苏。最后，可以考虑对难治性血管扩张性休克的新兴治疗方法，包括血管紧张素II、亚甲基蓝和羟钴胺素。总的来说，这篇综述提出了一种基于证据的分层方法来管理重症监护运输中难治性血管扩张性休克。

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引用次数: 0

Recognition and Management of Pseudo-Pulseless Electrical Activity in the Prehospital Setting 院前假无脉性电活动的识别与管理

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-18 DOI: 10.1016/j.amj.2025.08.011

Kelly M. Tillotson MD, Erica C. Blustein MD, James L. Li MD, M.Ed, Aaron J. Lacy MD, MHPE

引用次数: 0

The Race Against Sepsis: Are Helicopters Always Necessary? A Single-Center Analysis at a Tertiary Pediatric Hospital 与败血症的竞赛：直升机总是必要的吗？某三级儿科医院的单中心分析

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-17 DOI: 10.1016/j.amj.2025.08.005

Cari H. Rayborn MD, FAAP , Kaitlyn Clamp MS-II , Megan Sampson DO, FAAP , Rudy J. Kink MD, FAAP

Objective

Although numerous studies have evaluated transport modes for pediatric trauma, few have addressed strategies for sepsis. This study evaluates whether ground versus rotor wing transport affects transport time, hospital length of stay (LOS), or mortality in pediatric patients with suspected sepsis.

Methods

We performed a retrospective chart review at a 255-bed tertiary children’s hospital and level 1 trauma center (∼81,000 annual emergency department visits). Patients aged 0 to 18 years with a referring diagnosis of possible sepsis and transported by Pedi-Flite, a specialized neonatal/pediatric critical care team, between January 1, 2010, and January 1, 2020, were included; neonatal intensive care unit admissions were excluded. Data included demographics, transport time, fluid/antibiotic administration, vasopressor use, blood culture results, LOS, discharge disposition, and insurance status.

Results

Of 87 patients, 63 were transported by ground and 24 by rotor wing. Baseline characteristics and outcomes did not differ significantly. Mean transfer time was 150 ± 80 minutes for ground and 210 ± 297 minutes for rotor (P = .40). Team arrival to the referring hospital was 72 ± 51 minutes for ground and 125 ± 296 minutes for rotor (P = .40). LOS was 10.78 days (ground) versus 9.22 days (rotor; P = .6), and survival was 97% (rotor) versus 90% (ground; P = .40). Most patients received intravenous fluids (97%) and antibiotics (95%), with no group differences in administration rates or mean volume (33.4 vs. 33.3 mL/kg; P = .77). Vasopressors were started during transport in 10% and by the receiving hospital in 63%. In addition, 12 patients (14%) were intubated. Blood cultures were obtained in 40%, with 17% positive; no differences were observed between the groups (all P > .30).

Conclusion

Transport mode was not associated with differences in care or outcomes for suspected pediatric sepsis. In regions with similar geography and dispatch logistics, ground transport by a specialized critical care team may provide equivalent outcomes to rotor wing.

目的虽然许多研究已经评估了儿童创伤的转运方式，但很少有研究针对败血症的策略。本研究评估地面与旋翼运输是否影响运输时间，住院时间（LOS），或死亡率的儿科患者疑似败血症。方法：我们对一家拥有255个床位的三级儿童医院和一级创伤中心（每年约81,000次急诊就诊）进行回顾性图表回顾。纳入2010年1月1日至2020年1月1日期间，年龄在0至18岁，诊断为可能的败血症，并由儿科重症监护专科团队Pedi-Flite运送的患者；新生儿重症监护病房住院排除在外。数据包括人口统计、运输时间、液体/抗生素给药、血管加压剂使用、血培养结果、LOS、出院处置和保险状况。结果87例患者中，63例采用地面运输，24例采用旋翼运输。基线特征和结果无显著差异。地面平均转移时间为150±80分钟，转子平均转移时间为210±297分钟（P = 0.40）。地面小组到达转诊医院72±51分钟，旋翼小组到达转诊医院125±296分钟（P = 0.40）。LOS为10.78天（地面）vs 9.22天（旋翼），生存率为97%（旋翼）vs 90%（地面），P = 0.40。大多数患者接受静脉输液（97%）和抗生素（95%），在给药率和平均体积方面没有组间差异（33.4 mL/kg vs 33.3 mL/kg; P = 0.77）。10%的患者在运送途中开始使用血管加压药，63%的患者在接收医院开始使用血管加压药。此外，12例患者（14%）插管。40%进行血培养，阳性17%；各组间无差异（均P >； 30）。结论：运输方式与疑似儿童脓毒症的护理或结局差异无关。在地理位置和调度物流相似的地区，由专门的重症监护小组进行地面运输可以提供与旋翼相同的结果。

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引用次数: 0

Stroke Management in Critical Care Transport Medicine: A Consensus Statement 危重病转运医学卒中管理：共识声明

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-14 DOI: 10.1016/j.amj.2025.08.002

Mike Jasumback MD , Bryce Hill MD , Kaori Tanaka DO , Lesley Osborn MD , Seth Butler DO , Adam L. Gottula MD , Craig Tschautscher MD , Benjamin Lawner DO

Objective

The prehospital care of patients with acute ischemic stroke (AIS) is fraught with many challenges. Knowledge gaps within the prehospital care of patients with AIS contribute to inconsistent practices regarding diagnosis, pre-intervention positioning during transport, evaluation for stroke mimics, optimal patient destination, and hemodynamic management. The Air Medical Physician Symposium Lite held in Salt Lake City, Utah, gave experts in the field of critical care transport medicine (CCTM) a venue to discuss the current and optimal states of the prehospital patient with AIS.

Methods

The Air Medical Physician Symposium Lite was held on November 4, 2024, in Salt Lake City, Utah. Participants included international CCTM professionals. Attendees completed a survey on best practices, knowledge gaps, barriers to translation, and research priorities related to in-flight sedation and agitation protocols. The survey results informed lectures and panel discussions, followed by electronic audience voting to rank priority items.

Results

The analysis reveals significant challenges such as limited accuracy of AIS identification tools, unclear destination protocols, and conflicting guidelines for hemodynamic management. Effective blood pressure management in the prehospital setting and the impact on air medical transport on the outcome of patients with AIS remain the top research priorities.

Conclusion

This statement underscores the need for additional future studies and standardized guidelines in CCTM, emphasizing improved diagnostic tools, clear destination protocols, and evidence-based hemodynamic management to enhance outcomes for patients with AIS during critical care transport.

目的急性缺血性脑卒中（AIS）患者院前护理面临诸多挑战。AIS患者院前护理中的知识差距导致了诊断、转运过程中的干预前定位、卒中模拟评估、最佳患者目的地和血流动力学管理方面的不一致做法。在犹他州盐湖城举行的空中医师研讨会为重症监护运输医学（CCTM）领域的专家提供了一个讨论AIS院前患者当前和最佳状态的场所。方法于2024年11月4日在美国犹他州盐湖城召开航空内科医师研讨会。与会者包括国际CCTM专业人士。与会者完成了一项关于最佳实践、知识差距、翻译障碍以及与飞行镇静和躁动协议相关的研究重点的调查。调查结果为讲座和小组讨论提供了信息，然后由电子观众投票对优先事项进行排序。结果分析揭示了重大挑战，如AIS识别工具的准确性有限，目的地协议不明确，以及血流动力学管理指南相互冲突。院前环境中有效的血压管理以及空中医疗运输对AIS患者预后的影响仍然是研究的重中之重。这一声明强调了CCTM未来进一步研究和标准化指南的必要性，强调改进诊断工具、明确目的地协议和循证血流动力学管理，以提高AIS患者在重症监护转运期间的预后。

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引用次数: 0

Obstetric Transport and Factors Associated With Transport to the Intensive Care Unit 产科运输和与运输到重症监护病房相关的因素

Q3 Nursing

Air Medical Journal

Pub Date : 2025-09-13 DOI: 10.1016/j.amj.2025.08.006

Carly M. Dahl MD, MSCI , Michelle P. Debbink MD, PhD , Shelley Rogers RN , Lisa Pappas MS , Sunayna Wahi MS, MBA , Torri D. Metz MD, MS , Flint Porter MD , Marcela C. Smid MD, MS, MA

Obstetric transport to higher levels of maternal care for critically ill pregnant individuals is recommended to reduce maternal and neonatal morbidity, yet data on these transports are lacking. We aimed to describe the characteristics of obstetric transports of 1 integrated health system’s perinatal transport service from January 2020 to December 2023, with a specific focus on assessing factors associated with transport directly to an intensive care unit (ICU) rather than an emergency room or labor and delivery unit. During the study period, 1,087 obstetric transports occurred, most frequently for preterm labor (28.8%), preeclampsia (28.7%), and preterm prelabor rupture of membranes (18.7%). Transport most often occurred via rotor wing (48.0%). Transport to the ICU occurred in 3.2% of cases. Transport to the ICU was associated with longer physician consultation time (17.0 minutes [interquartile range 9.75-31.0] vs. 11.0 minutes [7.0-18.0], P = .006), shorter flight team dispatch time (13 minutes [8.0-33.0] vs. 20.0 minutes [13.5-29.0], P = .03), longer stabilization time before departure (19.0 minutes [15.0-33.0] vs. 15.0 minutes [12.0-20.0], P < .001), and longer time to load the patient to the aircraft (10.0 minutes [7.0-14.0] vs. 7.0 minutes [5.0-10.0], P = .002). Factors associated with transport to the ICU included a diagnosis of coronavirus disease 2019 (adjusted odds ratio [aOR], 11.85, 95% confidence interval [CI] 3.14-36.79), being postpartum (aOR 54.93, 95% CI 21.52-144.81), and further distance traveled (aOR 1.01 per mile traveled, 95% CI 1.00-1.01). Obstetric transports to the ICU are uncommon but require specialized patient care.

建议对危重孕妇进行产科转运至更高水平的孕产妇护理，以降低孕产妇和新生儿发病率，但缺乏有关这些转运的数据。我们旨在描述2020年1月至2023年12月1个综合卫生系统围产期运输服务的产科运输特征，特别侧重于评估与直接运输到重症监护病房（ICU）而不是急诊室或产房相关的因素。在研究期间，发生了1,087例产科转运，最常见的是早产（28.8%），先兆子痫（28.7%）和早产产前胎膜破裂（18.7%）。最常通过旋翼进行运输（48.0%）。3.2%的病例转至ICU。转至ICU的医生会诊时间较长（17.0分钟[四分位数区间9.75-31.0]vs. 11.0分钟[7.0-18.0],P = 0.006），机组调度时间较短（13分钟[8.0-33.0]vs. 20.0分钟[13.5-29.0],P = 0.03），起飞前稳定时间较长（19.0分钟[15.0-33.0]vs. 15.0分钟[12.0-20.0],P < 001），将患者送上飞机的时间较长（10.0分钟[7.0-14.0]vs. 7.0分钟[5.0-10.0],P = 0.002）。与转运至ICU相关的因素包括2019冠状病毒病的诊断（调整优势比[aOR]， 11.85, 95%可信区间[CI] 3.14-36.79）、产后（aOR 54.93, 95% CI 21.52-144.81）和路程更远（aOR 1.01 /英里，95% CI 1.00-1.01）。产科转运到ICU是罕见的，但需要专门的病人护理。

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