Air Medical Journal

Despite many advances in care, the mortality rate for cardiogenic shock remains high. Because the medical management of patients with cardiogenic shock is limited, many patients often require mechanical circulatory support. As such, cardiogenic shock patients requiring percutaneous ventricular support devices such as the Impella (Abiomed, Danvers, MA) may be encountered by critical care transport crews with increasing frequency. Recently, biventricular Impella support has been described as a mechanical support strategy for biventricular failure...

An unmarried pregnant woman felt lower abdominal pain. She rested in bed in her room on the second floor in her home. The next day she performed a delivery by herself. After the neonate cried, her parents noticed the birth and called an ambulance. After receiving the first call, the fire department decided to request the dispatch of a physician-staffed helicopter emergency medical service in Eastern Shizuoka, in addition to dispatching an ambulance. After receiving the request, the helicopter emergency medical service transported 1 neonatal intensive care unit physician along with the original medical staff members of the fire department...

Postpartum hemorrhage is a relatively common and highly morbid complication of the postpartum period that often requires management by specialized providers at tertiary care facilities. Critical care transport teams may be tasked with transporting postpartum patients who are already experiencing postpartum hemorrhage, but they should also be aware that other peripartum patients may be at risk for developing postpartum hemorrhage while in the process of transport. As such, it is imperative that transport providers understand the signs, symptoms, causes, and complications of postpartum hemorrhage as well as the options for intervention and treatment...

In 1993, the Southwest found itself staring down a disease then known as "unexplained adult respiratory syndrome." During the outbreak, 12 of 23 known patients died. What we now recognize as hantavirus cardiopulmonary syndrome still remains a rare and deadly disease. Although no cure exists, modern supportive techniques such as extracorporeal membrane oxygenation have increased survival among these patients. Early diagnosis has become the primary factor in patient survival. The initial presentation of hantavirus is similar to acute respiratory distress syndrome, necessitating a high index of suspicion to afford the patient the best chance of survival...

OBJECTIVE: The benefit and utility of a physician on a US-based air ambulance is an often-debated topic in the prehospital setting. There remains the question of what, if any, effect a physician crewmember has on patient outcome. Our goal was to assess the literature to date and determine if there exists a benefit to staffing air ambulances with physicians. METHODS: PubMed and Cochrane databases were searched for English language studies from 1980 to 2020 using the terms "flight physician" and "physician-staffed helicopter...

OBJECTIVE: Cardiac arrest leads to an array of metabolic disturbances. We aimed to investigate the association between prehospital blood glucose levels (BGLs) and rates of return of spontaneous circulation (ROSC) in non-traumatic out-of-hospital cardiac arrests (OHCAs). METHODS: A retrospective analysis of adult non-traumatic OHCAs within Kalamazoo County, MI, from January 2018 to May 2020 using the Michigan Emergency Medical Services Information System database was performed...

OBJECTIVE: We retrospectively investigated the current status of patients with atrioventricular block (AVB) who had been transported by the physician-staffed helicopter emergency medical service and their final outcome using data from the Japan Doctor Helicopter Registry (JDHR) system. METHODS: The following details of the dispatch activity were collected from the database of the JDHR: age and sex, vital signs when emergency medical technicians encountered the patient at the scene and on arrival at the receiving hospitals, contents of the medical intervention, new cardiac arrest during transportation, the main etiology of AVB, and the number of deaths in 1 month...

OBJECTIVE: The Finnish emergency medical services operates mainly with highly educated paramedic-staffed units. Helicopter emergency medical services (HEMS) physicians alongside other physicians provide consultations to paramedics on the scene without the physician physically participating in the mission. We examined the Finnish paramedics' views regarding the consultation processes involving HEMS physicians. METHODS: This was a cross-sectional survey study among paramedics (n = 200)...

OBJECTIVE: This is a retrospective quality review of LifeFlight Nova Scotia's prone patient transport protocol. METHODS: Electronic patient care records were queried for acute respiratory distress syndrome, prone position, proning, supine to prone, and prone to prone between February 2017 and June 2022. Eligible electronic patient care records were reviewed for demographics (sex, age, and weight); method of transports (ambulance, rotor wing, or fixed wing); duration of transports; mechanical ventilation parameters; medication infusions; arterial blood gases; occurrences of mild hypoxemia (any oxygen saturation [SpO2 ] < 88% or decrease in SpO2 > 5%); hypotension (any episode of MAP < 65 mm Hg); severe hypoxemia (any SpO2 < 80% or decrease in SpO2 > 10%); refractory hypotension (mean arterial pressure < 65 mm Hg not responsive to vasopressor/inotropes); cardiac arrests; and displacement of central lines, arterial lines, and endotracheal tubes...

OBJECTIVE: Fatigue is common in emergency medical services (EMS) and is exacerbated in air medical transport. There is no gold standard for recognizing high-risk factors contributing to fatigue. Current survey instruments designed to assess fatigue in EMS have limited evidence supporting their reliability and validity. The purpose of this study was to investigate the use of a team-based flight risk assessment tool (FRAT) as an instrument to improve safety and patient care for air medical transport...

OBJECTIVE: Studies have shown a bougie improves first-attempt success rates when used in combination with direct laryngoscopy during the initial attempt. The purpose of this study was to determine whether the use of a bougie in combination with C-MAC (Karl Storz, Tuttlingen, Germany) improves first-attempt success rates of endotracheal intubation (ETI) compared with C-MAC with a traditional stylet. METHODS: This study is a retrospective chart review using data collected on 371 intubations completed by a single air medical service using the C-MAC laryngoscope and either a bougie or a stylet...

OBJECTIVE: One of the most important benefits of helicopter emergency medical services (HEMS) is a time benefit, either through expedited access to the casualty or a reduction in the transport time to definitive care. However, HEMS utilization does not come without risk to the public and crew or at an insignificant cost. Cost is an essential consideration for health policy decisions, especially in low- to middle-income countries, such as South Africa. The aim of this study was to determine whether there is a time benefit of HEMS dispatch in South Africa compared with simulated driving time...

OBJECTIVE: Intubation is a vital skill performed by flight nurses and paramedics. Before flight training, nurses do not routinely intubate and must be trained in proper techniques. Flight paramedics universally train in intubation before flight training and are the primary managers of in-flight airways. The aim of this study was to determine if a difference exists in intubation attempts and success rates between flight nurses and flight paramedics. METHODS: A 5-year retrospective chart review was performed from a regional helicopter emergency medical service...

OBJECTIVE: Helicopter emergency medical services (HEMS) literature has been assessed in reviews focusing on various diagnoses, but there are few, if any, summaries of the entire body of HEMS outcomes evidence. Our goal was to summarize the existing research addressing patient-centered outcomes potentially accrued with HEMS. METHODS: As part of the Critical Care Transport Collaborative Outcomes Research Effort, we generated the HEMS Outcomes Assessment Research Database and executed descriptive analyses of longitudinal trends from 1983 to 2022...

OBJECTIVE: Optimal management of ischemic stroke is time dependent. An understanding of patterns of air medical transport may identify disparities that could affect patient care. METHODS: In this 8-year (2007-2014) observational, retrospective, cohort study, we abstracted a 20% national sample of Medicare data from patients ≥ 66 years of age hospitalized with a primary diagnosis of acute ischemic stroke who presented to the emergency department by ambulance (air or ground)...

In order to achieve the emission targets required by the German Federal Environment Agency (Umweltbundesamt), the offshore wind industry has become 1 of the central building blocks of the so-called "energy turnaround." After the first offshore wind farm (OWF), Alpha Ventus, started operation in 2010, the number of OWFs in the North Sea and Baltic Sea has grown steadily. Because of the ongoing growth of the industry, the number of workers on-site has more than quadrupled in recent years. Although the majority of OWFs are located in the exclusive economic zone up to 130 km from the mainland, the same legal provisions of the Occupational Health and Safety Act (Arbeitsschutzgesetz) apply here as on the mainland...

Training of the helicopter air ambulance medical professional has evolved over time with greater knowledge, experience, and innovations in pre- and intrahospital care. This article is a discussion of the training evolution of a historical, award-winning air medical program in the Southwest Virginia footprint.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.