Pub Date : 2025-07-21DOI: 10.1016/j.amj.2025.06.022
Hidekazu Hishinuma MSN , Takafumi Noguchi PhD , Kentaro Hayashi MD, PhD , Jin Kikuchi MD , Arata Honda MD , Noboru Iwata PhD , Gen Kobashi MD, PhD , Koji Wake MD, PhD
Objective
This study aimed to determine the impact of having 2 physicians versus 1 physician in a helicopter emergency medical team on OST.
Methods
This retrospective observational study analyzed 828 patients who underwent helicopter emergency medical services in 2 years (2020-2021). We used chi-square and t tests to analyze the difference in OST between patients attended by 1 versus 2 physicians. We then used general linear model analysis to evaluate the impact of the number of physicians on OST.
Results
Of the 828 patients, we observed 1 physician group (n = 356) and 2 physician groups (n = 472). Analysis revealed significant main effects of diagnosis type (F = 10.78, P < .001) and the number of physicians (F = 18.60, P < .001) on OST, whereas the interaction was not significant (F = 0.30, P = .911). In another analysis, the interaction between the transport facility and the number of physicians was significant (F = 7.00, P = .008), including their main effects.
Conclusions
Having 2 physicians on board the helicopter emergency medical services seems to reduce OST compared with having 1, particularly in trauma and neurology cases.
目的本研究旨在确定直升机紧急医疗队中2名医生与1名医生对OST的影响。方法回顾性观察分析2年内（2020-2021年）接受直升机紧急医疗服务的828例患者。我们使用卡方检验和t检验来分析1名医生与2名医生治疗的患者之间OST的差异。然后，我们使用一般线性模型分析来评估医生数量对OST的影响。结果在828例患者中，我们观察到1组医师（n = 356）和2组医师（n = 472）。分析显示，诊断类型（F = 10.78, P < 0.001）和医生数量（F = 18.60, P < 0.001）对OST有显著的主影响，交互作用不显著（F = 0.30, P = .911）。在另一项分析中，交通设施和医生数量之间的相互作用是显著的（F = 7.00, P = 0.008），包括它们的主要影响。结论在直升机紧急医疗服务中配备2名医生比配备1名医生更能降低OST，特别是在创伤和神经病学病例中。
{"title":"Association Between On-Scene Time and Number of Physicians in Helicopter Emergency Medical Services in Japan: A Retrospective Study","authors":"Hidekazu Hishinuma MSN , Takafumi Noguchi PhD , Kentaro Hayashi MD, PhD , Jin Kikuchi MD , Arata Honda MD , Noboru Iwata PhD , Gen Kobashi MD, PhD , Koji Wake MD, PhD","doi":"10.1016/j.amj.2025.06.022","DOIUrl":"10.1016/j.amj.2025.06.022","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the impact of having 2 physicians versus 1 physician in a helicopter emergency medical team on OST.</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed 828 patients who underwent helicopter emergency medical services in 2 years (2020-2021). We used chi-square and <em>t</em> tests to analyze the difference in OST between patients attended by 1 versus 2 physicians. We then used general linear model analysis to evaluate the impact of the number of physicians on OST.</div></div><div><h3>Results</h3><div>Of the 828 patients, we observed 1 physician group (<em>n</em> = 356) and 2 physician groups (<em>n</em> = 472). Analysis revealed significant main effects of diagnosis type (F = 10.78, <em>P</em> < .001) and the number of physicians (F = 18.60, <em>P</em> < .001) on OST, whereas the interaction was not significant (F = 0.30, <em>P</em> = .911). In another analysis, the interaction between the transport facility and the number of physicians was significant (F = 7.00, <em>P</em> = .008), including their main effects.</div></div><div><h3>Conclusions</h3><div>Having 2 physicians on board the helicopter emergency medical services seems to reduce OST compared with having 1, particularly in trauma and neurology cases.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 6","pages":"Pages 473-477"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371373","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}
We conducted a retrospective study to evaluate the clinical significance of antiemetic drug use in patients with seizures who were transported by physician-staffed helicopters (Doctor Helicopters [DHs]) in Japan.
Methods
Data retrieved included patient age, sex, presence or absence of cardiac arrest on DH staff contact, vital signs at the time of contact, details of medical interventions, duration of hospitalization, and final outcome. Patients who experienced cardiac arrest at the time of DH contact and those with missing final outcome data were excluded. Given the established prognostic significance of age and level of consciousness in patients with seizures, individuals younger than 46 years and those with a Glasgow Coma Scale score of <9 were excluded to minimize baseline variability between the 2 groups, based on the results of a preliminary analysis. Subjects were divided into the following 2 groups: the Control group (no antiemetic administered prehospital) and the Antiemetic group.
Results
The Control group included 532 patients, whereas the Antiemetic group comprised 149 patients. No significant differences were observed between the 2 groups in terms of sex, age, respiratory rate, systolic blood pressure, Glasgow Coma Scale score, mortality rate, or hospitalization rate. However, the Antiemetic group demonstrated a significantly lower rate of endotracheal intubation and a significantly better cerebral performance category score compared with the Control group.
Conclusion
This is the first study to evaluate the prognostic role of antiemetic use in older adults with seizures during helicopter transport in Japan. Future prospective, randomized, double-blind studies are warranted to determine whether the use of antiemetic agents serves as a prognostic factor in patients with seizures.
{"title":"Clinical Outcomes of Patients Experiencing Seizures Treated With Antiemetic Drugs During Transport by Physician-Staffed Helicopters in Japan","authors":"Youichi Yanagawa MD, PhD, Chihiro Maekawa MD, Noriko Tanaka MD, Namiko Suda MD, Yukinori Hirooka MD, Kenji Kawai MD, Michika Hamada MD, Hiroaki Taniguchi MD","doi":"10.1016/j.amj.2025.06.014","DOIUrl":"10.1016/j.amj.2025.06.014","url":null,"abstract":"<div><h3>Objective</h3><div>We conducted a retrospective study to evaluate the clinical significance of antiemetic drug use in patients with seizures who were transported by physician-staffed helicopters (Doctor Helicopters [DHs]) in Japan.</div></div><div><h3>Methods</h3><div>Data retrieved included patient age, sex, presence or absence of cardiac arrest on DH staff contact, vital signs at the time of contact, details of medical interventions, duration of hospitalization, and final outcome. Patients who experienced cardiac arrest at the time of DH contact and those with missing final outcome data were excluded. Given the established prognostic significance of age and level of consciousness in patients with seizures, individuals younger than 46 years and those with a Glasgow Coma Scale score of <9 were excluded to minimize baseline variability between the 2 groups, based on the results of a preliminary analysis. Subjects were divided into the following 2 groups: the Control group (no antiemetic administered prehospital) and the Antiemetic group.</div></div><div><h3>Results</h3><div>The Control group included 532 patients, whereas the Antiemetic group comprised 149 patients. No significant differences were observed between the 2 groups in terms of sex, age, respiratory rate, systolic blood pressure, Glasgow Coma Scale score, mortality rate, or hospitalization rate. However, the Antiemetic group demonstrated a significantly lower rate of endotracheal intubation and a significantly better cerebral performance category score compared with the Control group.</div></div><div><h3>Conclusion</h3><div>This is the first study to evaluate the prognostic role of antiemetic use in older adults with seizures during helicopter transport in Japan. Future prospective, randomized, double-blind studies are warranted to determine whether the use of antiemetic agents serves as a prognostic factor in patients with seizures.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 390-393"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886001","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}
Collaboration between ambulance emergency medical service (EMS) professionals and helicopter EMS (HEMS) physicians has not been extensively highlighted in the literature. This study aims to address this gap by exploring the perspectives of ambulance EMS professionals on their collaboration with the physician-staffed HEMS unit in Finland.
Methods
This survey study was conducted in Finland’s first rural physician-staffed HEMS unit’s, FinnHEMS40 (FH40), operating area in the autumn of 2023 and repeated after a year. A digital survey link was sent through e-mail to all EMS professionals working in ambulance units. The surveys consisted of 5-point Likert-scale questions, multiple-choice questions, and open-ended questions. Likert-scale answers were analyzed with contingency tables and the chi-square test and Fisher’s exact test.
Results
Response rates were 210 of 522 (40%) for the first survey and 200 of 518 (39%) for the second survey. Most of all respondents (90%) felt that collaboration with FH40 has been good or excellent. The opinions on the importance of a HEMS physician’s attendance on EMS missions depended on their educational background and previous work experience in EMS. Results indicated that EMS professionals with 2 to 5 years of work experience seemed to feel more confident in managing various EMS missions independently without assistance from a HEMS physician.
Conclusion
Collaboration between HEMS physicians and ambulance units is appreciated and deemed important among EMS professionals working in ambulances. Educational background and work experience influence opinions on the necessity of HEMS physicians’ attendance in EMS missions.
{"title":"Ambulance Emergency Medical Services Professionals’ Perspectives on Collaboration With Helicopter Emergency Medical Services Physicians","authors":"Elina Panula MD , Sami Länkimäki MD, PhD , Heini Huhtala MSc , Piritta Setälä MD, PhD , Sanna Hoppu MD, PhD","doi":"10.1016/j.amj.2025.06.018","DOIUrl":"10.1016/j.amj.2025.06.018","url":null,"abstract":"<div><h3>Objective</h3><div>Collaboration between ambulance emergency medical service (EMS) professionals and helicopter EMS (HEMS) physicians has not been extensively highlighted in the literature. This study aims to address this gap by exploring the perspectives of ambulance EMS professionals on their collaboration with the physician-staffed HEMS unit in Finland.</div></div><div><h3>Methods</h3><div>This survey study was conducted in Finland’s first rural physician-staffed HEMS unit’s, FinnHEMS40 (FH40), operating area in the autumn of 2023 and repeated after a year. A digital survey link was sent through e-mail to all EMS professionals working in ambulance units. The surveys consisted of 5-point Likert-scale questions, multiple-choice questions, and open-ended questions. Likert-scale answers were analyzed with contingency tables and the chi-square test and Fisher’s exact test.</div></div><div><h3>Results</h3><div>Response rates were 210 of 522 (40%) for the first survey and 200 of 518 (39%) for the second survey. Most of all respondents (90%) felt that collaboration with FH40 has been good or excellent. The opinions on the importance of a HEMS physician’s attendance on EMS missions depended on their educational background and previous work experience in EMS. Results indicated that EMS professionals with 2 to 5 years of work experience seemed to feel more confident in managing various EMS missions independently without assistance from a HEMS physician.</div></div><div><h3>Conclusion</h3><div>Collaboration between HEMS physicians and ambulance units is appreciated and deemed important among EMS professionals working in ambulances. Educational background and work experience influence opinions on the necessity of HEMS physicians’ attendance in EMS missions.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 409-415"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886045","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}
Pub Date : 2025-07-16DOI: 10.1016/j.amj.2025.06.024
Stephen Y. Liang MD, MPHS, Erika M. Robertson MD, SM, EMT-P, James L. Li MD, MEd, FAEMS, Aaron J. Lacy MD, MHPE, FACEP
{"title":"Something Old and Something New: Measles, Candida auris, and Infection Prevention in the Prehospital Setting","authors":"Stephen Y. Liang MD, MPHS, Erika M. Robertson MD, SM, EMT-P, James L. Li MD, MEd, FAEMS, Aaron J. Lacy MD, MHPE, FACEP","doi":"10.1016/j.amj.2025.06.024","DOIUrl":"10.1016/j.amj.2025.06.024","url":null,"abstract":"","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 333-335"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885123","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}
Helicopter emergency medical service (HEMS) personnel regularly respond to severe and life-threatening situations, often involving critically ill or injured patients. Yet limited research exists on their mental health outcomes compared with ground-based emergency medical services (EMS). This systematic review synthesizes empirical evidence on mental health symptoms among HEMS personnel, focusing on prevalence rates and key psychological outcomes.
Methods
A systematic search of PubMed, PsycINFO, and Scopus identified original, quantitative studies in English or Scandinavian languages. Studies were included if they reported on at least 1 mental health outcome of interest in HEMS personnel. Study quality was rated using criteria adapted from the National Institute of Health’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
Results
From 987 identified articles, 33 full texts were screened, and 9 studies were included, comprising 1 longitudinal and 8 cross-sectional designs. Six studies were rated as being fair quality, 2 as good, and 1 as poor. Outcomes evaluated included depression (5 studies), stress (5 studies), post-traumatic stress disorder/symptoms (PTSD; 3 studies), burnout (3 studies), anxiety (2 studies), secondary traumatic stress (1 study), and compassion fatigue (1 study). Across all studies, HEMS personnel reported low prevalence rates for mental health symptoms. However, burnout and depression were more frequently highlighted as concerns than PTSD.
Conclusion
Despite regular exposure to traumatic stressors, HEMS personnel report low levels of stress, PTSD, anxiety, and secondary traumatic stress, whereas burnout and depression had slightly higher levels, suggesting the need for targeted preventive interventions and support mechanisms within HEMS environments.
{"title":"Common Mental Health Symptoms in Personnel Working in Helicopter Emergency Medical Services: A Systematic Review","authors":"Karina Damsgaard MSc , Pernille Melander-Nyboe MSc , Jesper Pihl-Thingvad MSc, PhD , Jacob Steinmetz MD, PhD , Tine Bennedsen Gehrt MSc, PhD","doi":"10.1016/j.amj.2025.06.019","DOIUrl":"10.1016/j.amj.2025.06.019","url":null,"abstract":"<div><h3>Background</h3><div>Helicopter emergency medical service (HEMS) personnel regularly respond to severe and life-threatening situations, often involving critically ill or injured patients. Yet limited research exists on their mental health outcomes compared with ground-based emergency medical services (EMS). This systematic review synthesizes empirical evidence on mental health symptoms among HEMS personnel, focusing on prevalence rates and key psychological outcomes.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, PsycINFO, and Scopus identified original, quantitative studies in English or Scandinavian languages. Studies were included if they reported on at least 1 mental health outcome of interest in HEMS personnel. Study quality was rated using criteria adapted from the National Institute of Health’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.</div></div><div><h3>Results</h3><div>From 987 identified articles, 33 full texts were screened, and 9 studies were included, comprising 1 longitudinal and 8 cross-sectional designs. Six studies were rated as being fair quality, 2 as good, and 1 as poor. Outcomes evaluated included depression (5 studies), stress (5 studies), post-traumatic stress disorder/symptoms (PTSD; 3 studies), burnout (3 studies), anxiety (2 studies), secondary traumatic stress (1 study), and compassion fatigue (1 study). Across all studies, HEMS personnel reported low prevalence rates for mental health symptoms. However, burnout and depression were more frequently highlighted as concerns than PTSD.</div></div><div><h3>Conclusion</h3><div>Despite regular exposure to traumatic stressors, HEMS personnel report low levels of stress, PTSD, anxiety, and secondary traumatic stress, whereas burnout and depression had slightly higher levels, suggesting the need for targeted preventive interventions and support mechanisms within HEMS environments<em>.</em></div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 420-428"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886047","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}
The establishment of intraosseous (IO) access in patients with out-of-hospital cardiac arrest (OHCA) enables reliable vasopressor administration. However, no studies have examined the association between IO access and vasopressor administration in a nationwide prehospital setting. We aimed to examine the association between IO access and vasopressor administration in patients with OHCA using a nationwide database.
Methods
This retrospective cohort study used data from the Japanese Society for Aeromedical Services Registry (JSAS-R) between April 2020 and March 2023. The primary outcome was vasopressor administration before hospital arrival. Secondary outcomes included in-hospital mortality, length of hospital stay, doctor contact-to-hospital arrival time, and return of spontaneous circulation (ROSC) on hospital arrival. The association between IO access establishment and clinical outcomes was examined using multivariate logistic regression with multiple imputation.
Results
Among 3,264 patients with OHCA, 321 (9.8%) received IO access (IO group), while the remaining 2,943 (90.2%) who did not receive IO access formed the control group. Prehospital vasopressor administration was significantly more frequent in the IO group than in the control group (82.9% vs. 70.6%; p < 0.001; odds ratio [OR]: 1.77; 95% confidence interval [CI]: 1.28–2.46). However, the IO group showed a significant decrease in ROSC on hospital arrival (OR, 0.64; 95% CI: 0.45–0.91). No significant intergroup differences were observed in other secondary outcomes.
Conclusion
IO access was associated with increased prehospital vasopressor administration, suggesting higher success rates of IO vascular access among patients with OHCA in the helicopter emergency medical service setting.
目的建立院外心脏骤停（OHCA）患者骨内通道，实现可靠的血管加压药物给药。然而，在全国院前设置中，没有研究检查IO通路和血管加压剂给药之间的关系。我们的目的是通过一个全国性的数据库来研究OHCA患者的IO通路和血管加压药的使用之间的关系。方法本回顾性队列研究使用了2020年4月至2023年3月期间日本航空医疗服务协会（JSAS-R）的数据。主要终点是到达医院前血管加压药的使用。次要结局包括住院死亡率、住院时间、医生到达医院的时间和到达医院时的自然循环恢复（ROSC）。采用多变量逻辑回归和多重输入检验IO通路建立与临床结果之间的关系。结果3264例OHCA患者中，有321例（9.8%）接受了IO通路（IO组），其余2943例（90.2%）未接受IO通路（对照组）。IO组院前给药血管加压素的频率明显高于对照组（82.9% vs. 70.6%; p < 0.001；优势比[OR]: 1.77； 95%可信区间[CI]: 1.28-2.46）。然而，IO组在到达医院时ROSC显著降低（OR, 0.64; 95% CI: 0.45-0.91）。其他次要结果组间无显著差异。结论院前血管加压剂的使用增加了IO通道的使用，表明直升机紧急医疗服务环境下OHCA患者IO通道的成功率更高。
{"title":"Association Between Intraosseous Access Establishment and Prehospital Vasopressor Administration in Patients With Out-of-Hospital Cardiac Arrest in Helicopter Emergency Medical Services: Analysis of the Japanese Society for Aeromedical Services Registry","authors":"Hidemasa Kudo MD , Hiroyuki Ohbe PhD , Daisuke Kudo PhD , Tetsuya Sato PhD , Shigeki Kushimoto PhD","doi":"10.1016/j.amj.2025.06.016","DOIUrl":"10.1016/j.amj.2025.06.016","url":null,"abstract":"<div><h3>Objective</h3><div>The establishment of intraosseous (IO) access in patients with out-of-hospital cardiac arrest (OHCA) enables reliable vasopressor administration. However, no studies have examined the association between IO access and vasopressor administration in a nationwide prehospital setting. We aimed to examine the association between IO access and vasopressor administration in patients with OHCA using a nationwide database.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from the Japanese Society for Aeromedical Services Registry (JSAS-R) between April 2020 and March 2023. The primary outcome was vasopressor administration before hospital arrival. Secondary outcomes included in-hospital mortality, length of hospital stay, doctor contact-to-hospital arrival time, and return of spontaneous circulation (ROSC) on hospital arrival. The association between IO access establishment and clinical outcomes was examined using multivariate logistic regression with multiple imputation.</div></div><div><h3>Results</h3><div>Among 3,264 patients with OHCA, 321 (9.8%) received IO access (IO group), while the remaining 2,943 (90.2%) who did not receive IO access formed the control group. Prehospital vasopressor administration was significantly more frequent in the IO group than in the control group (82.9% vs. 70.6%; <em>p</em> < 0.001; odds ratio [OR]: 1.77; 95% confidence interval [CI]: 1.28–2.46). However, the IO group showed a significant decrease in ROSC on hospital arrival (OR, 0.64; 95% CI: 0.45–0.91). No significant intergroup differences were observed in other secondary outcomes.</div></div><div><h3>Conclusion</h3><div>IO access was associated with increased prehospital vasopressor administration, suggesting higher success rates of IO vascular access among patients with OHCA in the helicopter emergency medical service setting.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 399-403"},"PeriodicalIF":0.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885835","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}
Pub Date : 2025-07-11DOI: 10.1016/j.amj.2025.06.017
Jennifer K. Pfister DNP, ACPNP, C-NPT , Katie L. McDermott PhD, MEHP, ACPNP , Christine A. Schindler PhD, DNP, ACPNP , Tara L. Petersen MD, MSEd , Ke Yan PhD , Melodee A. Liegl MA , Prakadeshwari Rajapreyar MD, MBA
Background
Pediatric critical care medicine (PCCM) fellowship programs must meet established educational standards; however, interfacility transport opportunities vary across sites.
Objective
To query key stakeholders, is the interfacility transport medicine rotation still an important component of the PCCM fellowship?
Methods
A multi-methods questionnaire was sent to a convenience sample (n = 66) of key stakeholders, including attending physicians, PCCM fellows, and transport team members, from a single site. An 80% response rate resulted in a total of 53 participants. Quantitative items used a Likert-scale and forced ranking response options. Qualitative responses were obtained regarding challenges and barriers during the rotation and to discern attributes of a successful fellow on transport.
Results
The transport rotation was rated as important by 92% of the respondents (n = 53). Identified challenges included autonomy, decision-making, and teamwork. All stakeholder groups similarly ranked medical control principles as the most important. Fellows ranked flight physiology as highly important, whereas attending physicians and transport team members ranked medical protocols as highly important.
Conclusion
A transport medicine rotation during PCCM fellowship is important and highly valued by key stakeholders. Differences in perceptions exist regarding topics of importance and qualities of a successful provider performing medical transport across the stakeholder groups.
{"title":"The Importance of a Transport Medicine Rotation for a Pediatric Critical Care Fellowship","authors":"Jennifer K. Pfister DNP, ACPNP, C-NPT , Katie L. McDermott PhD, MEHP, ACPNP , Christine A. Schindler PhD, DNP, ACPNP , Tara L. Petersen MD, MSEd , Ke Yan PhD , Melodee A. Liegl MA , Prakadeshwari Rajapreyar MD, MBA","doi":"10.1016/j.amj.2025.06.017","DOIUrl":"10.1016/j.amj.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div><span>Pediatric </span>critical care medicine (PCCM) fellowship programs must meet established educational standards; however, interfacility transport opportunities vary across sites.</div></div><div><h3>Objective</h3><div>To query key stakeholders, is the interfacility transport medicine rotation still an important component of the PCCM fellowship?</div></div><div><h3>Methods</h3><div>A multi-methods questionnaire was sent to a convenience sample (<em>n</em> = 66) of key stakeholders, including attending physicians, PCCM fellows, and transport team members, from a single site. An 80% response rate resulted in a total of 53 participants. Quantitative items used a Likert-scale and forced ranking response options. Qualitative responses were obtained regarding challenges and barriers during the rotation and to discern attributes of a successful fellow on transport.</div></div><div><h3>Results</h3><div>The transport rotation was rated as important by 92% of the respondents (<em>n</em><span> = 53). Identified challenges included autonomy, decision-making, and teamwork. All stakeholder groups similarly ranked medical control principles as the most important. Fellows ranked flight physiology as highly important, whereas attending physicians and transport team members ranked medical protocols as highly important.</span></div></div><div><h3>Conclusion</h3><div>A transport medicine rotation during PCCM fellowship is important and highly valued by key stakeholders. Differences in perceptions exist regarding topics of importance and qualities of a successful provider performing medical transport across the stakeholder groups.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 404-408"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886044","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}
Pub Date : 2025-07-10DOI: 10.1016/j.amj.2025.06.015
Matthew R. Shaw MPH, FP-C, CCP-C , Joseph Liu DO , Nicholas Segel DO , Michael Hudson MD , Iv Godzdanker MD , Zachary Lyman EdD, FP-C , Tricia Miedema MD , Holly Tallman MD , Joshua B. Gaither MD
Objective
Debate exists on how to best immobilize the cervical spine in the prehospital setting. Rigid cervical collars have been considered the standard of care for both the prevention and care of patients with suspected cervical spinal cord injury (c-SCI). Recently, soft c-collars have begun replacing rigid collars as they are better tolerated by patients. The aim of this study was to compare the safety of these 2 devices by evaluating the prevalence of c-SCI in patients immobilized with a rigid c-collar with those in a soft c-collar.
Methods
A retrospective review of data collected for the purpose of quality improvement was conducted. All cases with possible c-SCI were included. Cases with missing hospital International Classification of Disease code or documentation of emergency medical service neurologic examination were excluded. The primary outcome was c-SCI diagnosis at hospital discharge. A secondary outcome was the prevalence of c-SCI among those at high risk for c-SCI. Descriptive and chi-square analyses were completed to compare the cohorts.
Results
Of 882 patients with possible c-SCI, 267 were placed in a rigid collar and 615 in soft collars. Respectively, of those in the rigid and soft collar groups, the median age was 36 (interquartile range 24.5-53) years and 39 (interquartile range 24-58) years, and 54% (134) versus 64% (313) were male. Incidence of c-SCI was 0.8% in the rigid c-collar versus 1.5% in the soft collar group (P = .460). Among those cases with neurologic deficit noted by emergency medical services, there was no difference in incidence of c-SCI in the rigid (2/29, 6.9%) versus the soft (5/87, 5.7%) collar groups (P = .833).
Conclusion
In this limited retrospective review, no statistically significant difference in the rates of c-SCI was observed between patients who were immobilized using a rigid versus soft c-collar. Additional investigation is needed to determine whether rigid and soft c-collars provide equal protection.
{"title":"Association Between Collar Type and Incidence of Cervical Spinal Cord Injury in Trauma Patients","authors":"Matthew R. Shaw MPH, FP-C, CCP-C , Joseph Liu DO , Nicholas Segel DO , Michael Hudson MD , Iv Godzdanker MD , Zachary Lyman EdD, FP-C , Tricia Miedema MD , Holly Tallman MD , Joshua B. Gaither MD","doi":"10.1016/j.amj.2025.06.015","DOIUrl":"10.1016/j.amj.2025.06.015","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>Debate exists on how to best immobilize the cervical spine in the prehospital setting. Rigid </span>cervical collars<span> have been considered the standard of care for both the prevention and care of patients with suspected </span></span>cervical spinal cord injury (c-SCI). Recently, soft c-collars have begun replacing rigid collars as they are better tolerated by patients. The aim of this study was to compare the safety of these 2 devices by evaluating the prevalence of c-SCI in patients immobilized with a rigid c-collar with those in a soft c-collar.</div></div><div><h3>Methods</h3><div><span><span>A retrospective review of data collected for the purpose of quality improvement was conducted. All cases with possible c-SCI were included. Cases with missing hospital </span>International Classification of Disease code or documentation of emergency medical service </span>neurologic examination<span> were excluded. The primary outcome was c-SCI diagnosis at hospital discharge. A secondary outcome was the prevalence of c-SCI among those at high risk for c-SCI. Descriptive and chi-square analyses were completed to compare the cohorts.</span></div></div><div><h3>Results</h3><div>Of 882 patients with possible c-SCI, 267 were placed in a rigid collar and 615 in soft collars. Respectively, of those in the rigid and soft collar groups, the median age was 36 (interquartile range 24.5-53) years and 39 (interquartile range 24-58) years, and 54% (134) versus 64% (313) were male. Incidence of c-SCI was 0.8% in the rigid c-collar versus 1.5% in the soft collar group (<em>P</em> = .460). Among those cases with neurologic deficit noted by emergency medical services, there was no difference in incidence of c-SCI in the rigid (2/29, 6.9%) versus the soft (5/87, 5.7%) collar groups (<em>P</em> = .833).</div></div><div><h3>Conclusion</h3><div>In this limited retrospective review, no statistically significant difference in the rates of c-SCI was observed between patients who were immobilized using a rigid versus soft c-collar. Additional investigation is needed to determine whether rigid and soft c-collars provide equal protection.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 394-398"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886002","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}
Pub Date : 2025-06-30DOI: 10.1016/j.amj.2025.05.006
Carlo Bellini MD, PhD , Luca A. Ramenghi MD, PhD , Giovanni Serra MD
On February 1, 2025, the Neonatal Emergency Transport Service (NETS) at Gaslini Hospital in Genoa, Italy, marked an extraordinary milestone: 30 years of dedicated service. Since its establishment, NETS Gaslini has been a beacon of hope, providing rapid responses and transporting > 8,000 critically ill newborns. Each transport represents a unique story of urgency, swift action, and compassionate care. This article honors NETS Gaslini’s remarkable journey, tracing its origins and evolution and celebrating the countless lives it has touched. Through heartfelt anecdotes and pivotal moments, we celebrate 3 decades of unwavering commitment to saving the most fragile lives.
{"title":"Gaslini Neonatal Emergency Transport Service. Celebrating 30 Years of Activity, 1995-2025","authors":"Carlo Bellini MD, PhD , Luca A. Ramenghi MD, PhD , Giovanni Serra MD","doi":"10.1016/j.amj.2025.05.006","DOIUrl":"10.1016/j.amj.2025.05.006","url":null,"abstract":"<div><div><span>On February 1, 2025, the Neonatal Emergency Transport Service (NETS) at Gaslini Hospital in Genoa, Italy, marked an extraordinary milestone: 30 years of dedicated service. Since its establishment, NETS Gaslini has been a beacon of hope, providing rapid responses and transporting > 8,000 critically ill </span>newborns. Each transport represents a unique story of urgency, swift action, and compassionate care. This article honors NETS Gaslini’s remarkable journey, tracing its origins and evolution and celebrating the countless lives it has touched. Through heartfelt anecdotes and pivotal moments, we celebrate 3 decades of unwavering commitment to saving the most fragile lives.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"44 5","pages":"Pages 338-346"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885125","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}
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