Air Medical Journal最新文献

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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

引用次数: 0

UCAN Make a Difference: Over 40 Years of Flying High Above Chicago UCAN做出改变：在芝加哥上空飞行40多年

Q3 Nursing

Air Medical Journal

Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.08.008

Meaghan J. Panfil MSN, RN, CFRN , Caitlin Kilcoyne BSN, RN, CFRN, C-NPT , Julianne Heiple MSN, APN, RN, FNP-C, CFRN , Ira J. Blumen MD, FACEP, FAMPA , Candice Schaper MSN, RN, CFRN, CCRN, CEN, PHRN , Michael P. McCartin MD

The University of Chicago Aeromedical Network (UCAN) was established in 1983 and has been providing critical care transport via both air and ground in and around the Chicago area for over 40 years. Over that time, the program has transported thousands of critically ill individuals, including complex specialty populations, while also maintaining a safe transport environment for its crew members and patients. UCAN has had a profound impact not only on its patients, but also on the entire transport community by providing continuing education, conducting vital safety research while maintaining the highest safety standards, and driving the industry forward through service and leadership. Since inception, the program has experienced many changes, including the transition from a traditional hospital-based program to an alternate delivery model and the conversion of the crew from a nurse-physician team to a nurse-nurse configuration. These changes have allowed for continuous evolution within UCAN, including the introduction of internal process improvements that focus on quality, safety and education, growth of the communications team and its capabilities, and expansion of UCAN's commitment to outreach and education for its community partners.

芝加哥大学航空医疗网络（UCAN）成立于1983年，40多年来一直在芝加哥地区及其周边地区通过空中和地面提供重症监护运输。在此期间，该项目运送了数千名重症患者，包括复杂的专科患者，同时也为其机组人员和患者保持了安全的运输环境。UCAN不仅对患者产生了深远的影响，而且通过提供继续教育，在保持最高安全标准的同时进行重要的安全研究，并通过服务和领导推动行业发展，对整个运输界产生了深远的影响。自启动以来，该计划经历了许多变化，包括从传统的以医院为基础的计划转变为替代交付模式，以及将工作人员从护士-医生团队转变为护士-护士配置。这些变化使得UCAN内部不断发展，包括引入以质量、安全和教育为重点的内部流程改进，通信团队及其能力的增长，以及UCAN对社区合作伙伴的推广和教育的承诺的扩大。

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引用次数: 0

Sedation Management in the Intubated Pediatric Patient as a Method to Reduce Neuromuscular Blockade Utilization Rate During Transport: A Quality Improvement Project 镇静管理在插管儿童患者作为一种方法，以减少在运输过程中的神经肌肉阻滞使用率：一个质量改进项目

Q3 Nursing

Air Medical Journal

Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.07.008

Laura Lyons BSN, RN, CCRN, EMT-B , Jennifer Minehart MSN, RN , Christine Perebzak MSN, RN, CNS , Kerwyn Jones MD , Michael T. Bigham MD, MBA , Jeffrey Naples DO

Objective

Models recommending continuous sedation combined with specific tools to assess sedation depth during pediatric transport do not exist. Published studies demonstrate that nurse-driven sedation protocols yield more consistent levels of appropriate sedation.

Methods

A retrospective review in 2020 of mechanically ventilated pediatric transport patients at this institution demonstrated that 60.7% received neuromuscular blockade. This higher than anticipated neuromuscular blockade usage indicated an opportunity to improve sedation management. The primary aim of this quality improvement project is to decrease neuromuscular blockade use to < 30% of intubated pediatric patients cared for by our critical care transport team. To achieve this, we aimed to improve patient sedation by increasing the use of continuous sedation medication infusions to > 75% of patients by the first quarter of 2022. The initiative took place with a hospital-based pediatric/neonatal critical care transport team.

Results

Continuous sedation infusions increased using protocolized sedation from 10.7% at baseline to a sustained rate of 88% with dexmedetomidine (76.3%) and propofol (13.6%) as primary medications. The percentage of patients receiving neuromuscular blockade decreased in stepwise fashion from the initial 60.7% to 8.3%.

Conclusion

This project demonstrated sustained improvement in continuous sedation and decrease in neuromuscular blockade use through the initiation of a continuous sedation protocol in transport.

目的不存在推荐持续镇静并结合特定工具评估儿童运输过程中镇静深度的模型。已发表的研究表明，护士驱动的镇静方案产生更一致的适当镇静水平。方法对2020年我院机械通气患儿进行回顾性分析，60.7%的患儿接受了神经肌肉阻滞治疗。这高于预期的神经肌肉阻断使用表明有机会改善镇静管理。这个质量改进项目的主要目的是减少神经肌肉阻断剂的使用。30%的插管儿科病人由我们的重症监护转运小组照顾。为了实现这一目标，我们的目标是通过增加镇静药物持续输注的使用来改善患者的镇静。到2022年第一季度，75%的患者。该倡议是与医院的儿科/新生儿重症监护转运小组一起开展的。结果以右美托咪定（76.3%）和异丙酚（13.6%）为主要药物，连续镇静输注使用方案镇静的比例从基线时的10.7%增加到88%。接受神经肌肉阻断治疗的患者比例从最初的60.7%逐步下降到8.3%。结论：该项目表明，通过在运输中启动持续镇静方案，持续镇静的持续改善和神经肌肉阻断的使用减少。

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引用次数: 0

Epidemiology and Expected Cost of International Medical Repatriation Into South Korea: 2019 to 2021 国际医疗遣返韩国的流行病学和预期成本：2019年至2021年

Q3 Nursing

Air Medical Journal

Pub Date : 2024-11-01 DOI: 10.1016/j.amj.2024.10.005

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

Objective

Overseas Koreans face challenges in accessing adequate medical care abroad. Understanding the epidemiology and costs of international medical repatriation is important.

Methods

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.

Results

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.

Conclusion

International medical repatriation is significant for overseas Koreans. Standardized guidelines and system development are essential for effective air medical services.

目的海外韩国人在获得国外适当医疗保健方面面临挑战。了解国际医疗遣返的流行病学和费用很重要。方法对2019 ~ 2021年回国的海外韩国人患者进行回顾性分析。从121个国家收集的数据包括人口统计、医疗条件和费用。对来自9大洲（东南亚、东北亚、西南亚太、俄罗斯-中亚、北美、中南美洲、欧洲、中东-北非和撒哈拉以南非洲）和2019年冠状病毒病时代（2020年2月及以后）的变量进行分析和比较。根据可获得的总成本数据，对总队列进行逐步外推。结果本研究共纳入428例通过航空运输进行国际医疗遣返的海外朝鲜族患者。从东南亚地区遣返的患者最多（108例），在2019冠状病毒病时代内遣返的患者279例。每位患者的平均费用超过7000美元，根据外推法估计，总费用超过800万美元。结论国际医疗遣返对侨胞具有重要意义。标准化准则和系统开发对于有效的空中医疗服务至关重要。

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引用次数: 0

Recent Outcomes Research in Helicopter Emergency Medical Services: A Scoping Review of Publication Year 2023 Additions to the Helicopter Outcomes Assessment Research Database 直升机紧急医疗服务最新成果研究：直升机成果评估研究数据库 2023 年新增出版内容的范围审查

Q3 Nursing

Air Medical Journal

Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.05.002

Objective

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).

Methods

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.

Results

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 (P = .779), geographic origin (P = .171), and JIF (P = .531).

Conclusion

This scoping review provides information on 18 HEMS outcomes studies new to the evidence base in 2023.

方法根据《系统综述和荟萃分析的首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews）指南，采用多位审稿人的方法对 2023 年以来已发表或预印本数据库中的文章进行筛选和审稿。所收录的文章评估了以患者为中心的结果，即直升机急救服务与非直升机急救服务对照组的比较。文章特征包括期刊影响因子（JIF）、诊断组别（创伤或非创伤）和地域来源。将 2023 篇研究与前十年（2013-2022 年）的 HOARD 研究进行比较，采用费舍尔精确检验法进行分类分析；对非正态分布的 JIF 数据采用中位数和四分位数间距进行描述，并采用秩和检验法进行分析（与 2013-2022 年相比）。其中 58 项被放弃，18 项被归类为符合加入 HOARD 的条件。大多数研究（14/18，78%）侧重于创伤，来自北美的研究比例同样很高（14/18，78%）。JIF的中位数为2.4（四分位间范围为1.2-3.6）。与前十年的 HOARD 研究相比，2023 年的研究在诊断重点（P = .779）、地域来源（P = .171）和 JIF（P = .531）方面相似。

{"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}

引用次数: 0

Airway and Ventilator Management in a New Presentation of Idiopathic Subglottic Stenosis: A Case Report 特发性声门下狭窄新病例的气道和呼吸机管理：病例报告

Q3 Nursing

Air Medical Journal

Pub Date : 2024-09-01 DOI: 10.1016/j.amj.2024.06.002

Rebecca K. Bell MD , Skyler A. Lentz MD , Jeremy C. Patten NRP , Patricia Ruth A. Atchinson DO , Matthew A. Roginski MD, MPH

In the acute setting, subglottic stenosis 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 mechanical ventilation of this rare but life-threatening condition.

在急性期，声门下狭窄给气道管理带来了独特的挑战，尤其是在没有亚专科护理的情况下。我们介绍了一例在社区医院治疗的特发性声门下狭窄并发急性呼吸窘迫的病例，以突出这种罕见但危及生命的疾病在诊断、初始气道管理和机械通气方面的挑战。

引用次数: 0

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