Air Medical Journal最新文献

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Articles That May Change Your Practice: Whole Blood for Traumatic Hemorrhagic Shock 文章可能改变你的做法：全血治疗创伤性失血性休克

Q3 Nursing

Air Medical Journal

Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.07.010

Russell D. MacDonald MD, MPH, FCFP, FRCPC, DRCPSC, Blake A. Forte MD, MHS, MS, Michael D. Stocker MD, MPH, Aaron J. Lacy MD, FAWN

引用次数: 0

The RACE Scale for Large Vessel Stroke Diversion to a Comprehensive Stroke Center by Helicopter Air Ambulance: A Retrospective Cohort Study 直升机空中救护将大血管卒中转移到综合卒中中心的RACE量表：一项回顾性队列研究

Q3 Nursing

Air Medical Journal

Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.07.011

William Krebs DO, RDMS, EMT-P , Melina Alexander DO , Alisha Fujita DO , Quinci Copeland MD , Nancy Buderer MS , Osama Zaidat MD , Eugene Lin MD

Objective

Acute ischemic stroke caused by large vessel occlusion (LVO) occurs frequently and benefits from endovascular therapies available at comprehensive stroke centers (CSCs). Prehospital stroke severity tools have been devised to detect LVO. The goal of this study was to assess the value of the Rapid Arterial Occlusion Evaluation (RACE) score in helicopter air ambulance (HAA) activation.

Methods

A retrospective assessment of RACE scales > 4 performed by prehospital providers was used in order to activate HAAs. Descriptive statistics were obtained for patients transported, with the primary goal of determining the positive predictive values of the RACE scale for LVO occlusions. The secondary outcomes assessed if patients without LVO had other conditions requiring a CSC.

Results

Data from 136 subjects were analyzed; 53 (39.0%) were true LVO cases as defined by computed tomographic imaging, computed tomography angiographic imaging, or magnetic resonance imaging. Mechanical thrombectomy occurred in 30 cases (22.1%), with 63 (46.4%) requiring a neurologic intervention. There were 83 (61%) false positives (no LVO on imaging). Of these false positives, 28 (20.6%) were non-LVO strokes, 22 (16.1%) were intracranial hemorrhages, and 8 (5.9%) had neurologic conditions requiring CSC care.

Conclusion

A RACE scale > 4 is an effective triage tool that delivers potential thrombectomy candidates to CSCs. When there is a false positive, the majority of patients require CSC care and benefit from direct transport from the scene.

目的：大血管闭塞（LVO）引起的急性缺血性脑卒中发生频繁，并受益于综合卒中中心（CSCs）提供的血管内治疗。院前卒中严重程度工具已被设计用于检测LVO。本研究的目的是评估快速动脉闭塞评估（RACE）评分在直升机空中救护（HAA）激活中的价值。方法回顾性评价RACE量表；采用院前提供者进行的4例以激活HAAs。对运送的患者进行描述性统计，主要目的是确定RACE量表对左心室闭塞的阳性预测值。次要结果评估如果没有LVO的患者有其他需要CSC的情况。结果共分析136例受试者的资料；53例（39.0%）通过计算机断层成像、计算机断层血管成像或磁共振成像诊断为真正的LVO病例。机械取栓30例（22.1%），其中63例（46.4%）需要神经系统干预。83例（61%）假阳性（影像学无LVO）。在这些假阳性中，28例（20.6%）为非lvo卒中，22例（16.1%）为颅内出血，8例（5.9%）为需要CSC护理的神经系统疾病。结论RACE量表；4是一种有效的分诊工具，可为csc提供潜在的血栓切除候选物。当出现假阳性时，大多数患者需要CSC护理，并从现场直接运输中受益。

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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 : 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

Q3 Nursing

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

Objective

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.

Methods

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.

Results

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).

Conclusion

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.

目的与城市社区相比，农村社区患者的死亡率有所上升。直升机紧急医疗服务减少了来自农村地区的病人到达医院的时间和创伤死亡率。接受医疗急救服务的城市居民数量不详。我们的目标是量化居住在卫生紧急医疗服务基地邻近城市的城市居民的比例，当他们在农村地区时，由直升机转移。方法回顾性分析1985 ~ 2022年的HEMS图表。评估了患者所在城市和邮政编码的记录。搜索了二级数据库以评估特派团地点。结果共分析病例35000 971例；3871例（10.76%）患者居住在开放HEMS基地的市区，32100例（89.24%）患者居住在非市区。这与在城市地区执行的所有特派团的2.04%形成对比。与患者一起从3个省以外飞来的病例如下：不列颠哥伦比亚省（1,233/21,941）；艾伯塔省5.3%的病例)，国际(988/35,971；占总病例的2.7%)，安大略省(177/4,691；占马尼托巴省病例的3.6%)，其他省份合计(158/3,5971；占总病例的0.4%)。结论：我们强调医疗卫生服务的影响，它既服务于农村居民，也服务于所有在医疗卫生服务支持的地区工作、旅行、访问或娱乐的人。

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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

Q3 Nursing

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

Objective

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.

Methods

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.

Results

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 (P = .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 (P < .001).

Conclusion

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.

目的异丙醇（IPA）芳香疗法能以最低的成本快速缓解恶心，是普遍可用的，并且没有已知的显著不良反应。这些属性使其成为院前设置的理想选择。然而，在重症监护运输（CCT）中使用IPA的研究尚未发表。本研究的目的是调查CCT患者是否通过IPA芳香疗法改善恶心症状。方法对中西部地区提供空中和地面运输的CCT系统服务的成人患者进行了为期2年的回顾性图表回顾。数据是在方案改变前1年和改变后1年获得的，其中一线止吐剂从静脉注射昂丹司琼（改变前）改为吸入IPA（改变后）。IPA是通过在患者吸入时在他们的鼻子下放置一个垫子来管理的。比较改变前后恶心症状改善的比例。结果共纳入病历217份。在直升机紧急医疗服务中，50例患者中有33例（66.0%）报告昂丹司琼改善，21例患者中有13例（61.9%）报告IPA改善（P = .742）。地面紧急医疗服务运送的患者中，使用昂丹司琼的73例中有65例（89.0%）得到改善，使用IPA的73例中有40例（54.8%）得到改善。措施)。结论直升机紧急医疗服务患者使用昂丹司琼与IPA后恶心症状改善比例无显著差异。在地面紧急医疗服务患者中，与IPA相比，使用昂丹司琼改善恶心症状的患者更多。本研究提示IPA可能是缓解CCT患者恶心的更快、更有效的替代方案。

{"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

Q3 Nursing

Air Medical Journal

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

Carlo Bellini MD, PhD

Following a previous article that described the early days of Italian air rescue and that reached up to the immediate postwar period (World War II), this article describes the search and rescue activity carried out by the Italian Grumman Albatross HU-16A from the postwar period until the end of the 70s.

继前一篇文章，描述了早期的意大利空中救援，并达到了直接战后时期（第二次世界大战），这篇文章描述了搜索和救援活动进行了意大利格鲁曼信天翁胡- 16a从战后时期直到70年代末。

引用次数: 0

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

Q3 Nursing

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

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

目的外伤性脑损伤（tbi）是世界范围内导致死亡和残疾的主要原因之一。建立创伤性脑损伤指南对院前管理至关重要。平民医疗实践经常受到军事创伤准则的影响。本研究采用国防部联合创伤系统的民用指南和军事临床实践指南，对民用航空医疗后送服务的院前TBI管理进行了比较分析。方法回顾性分析某著名民用航空医疗服务机构100例未确定身份的病人运输日志。这些日志与该服务的患者护理指南和2023年关节创伤系统临床实践指南进行了比较。对14个指标的依从性进行数据分析。结果患者在飞行前和飞行后的格拉斯哥昏迷量表评分均有改善，并根据两个组织对头部抬高、氧合、血压和体温的建议进行管理。指南之间的差异包括呼吸机设置、血压、氧合、体温、血清葡萄糖、颅内高压、疑似脑疝、血清钠水平和癫痫预防的管理差异。结论：比较民用和军用指南突出了TBI管理的潜在改进领域，例如在航空运输中整合先进的监测和实施（i-STAT, Abbott Laboratories, Chicago， IL）测试，以提高患者护理和结果。

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引用次数: 0

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

Q3 Nursing

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

Q3 Nursing

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

Cardiac arrest in pregnancy is a rare but serious complication, occurring at a rate of 1 in every 9,000 patients hospitalized for delivery. This review article provides a comprehensive overview of maternal cardiac arrest for critical care transport providers. This article discusses the pertinent physiologic changes in pregnancy, common contributing factors, and special circumstances that can develop during a maternal cardiac arrest. We also provide current approaches to managing this population and special considerations for transport providers.

妊娠期心脏骤停是一种罕见但严重的并发症，每9 000名住院分娩患者中发生1例。这篇综述文章提供了一个全面的概述产妇心脏骤停重症监护运输提供者。本文讨论了妊娠期相关的生理变化，常见的影响因素，以及在母体心脏骤停期间可能发生的特殊情况。我们还提供了管理这一人口的当前方法以及运输供应商的特殊考虑。

引用次数: 0

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

Q3 Nursing

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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