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    1119 results match your criteria Air Medical Journal [Journal]

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    Air Transport of a Patient With Impending Cerebral Herniation From Tension Pneumocephalus.
    Air Med J 2018 Jan - Feb;37(1):71-73. Epub 2017 Nov 7.
    Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT. Electronic address:
    Tension pneumocephalus is a rare but dangerous complication of craniotomy, sinus surgery, and traumatic cranial injury. Compared with simple pneumocephalus, which often resolves spontaneously over the course of a few days, tension pneumocephalus tends to increase with ongoing cerebrospinal fluid leak and requires immediate neurosurgical treatment to prevent cerebral herniation. Air transport of patients with tension pneumocephalus for neurosurgical care entails a risk of neurologic worsening because of changes in ambient air pressure with altitude and cabin pressurization. Read More

    Long-Distance, Nonstop Neonatal Transport From Shanghai, China, to Genoa, Italy.
    Air Med J 2018 Jan - Feb;37(1):67-70. Epub 2017 Nov 6.
    Neonatal Intensive Care UnitNeonatal Emergency Transport ServiceIRCCS Istituto Giannina GasliniGenoaItaly.
    The purpose of this article is to describe the long-distance, nonstop intercontinental transport of a severely ill, mechanically ventilated newborn from Shanghai, China, to Genoa, Italy focusing in particular on the clinical and planning difficulties. The aircraft equipment, the assessment and preparation for transport are discussed. Read More

    Pediatric Extracorporeal Cardiopulmonary Resuscitation Patient With Traumatic Subarachnoid Hemorrhage and Takotsubo Syndrome.
    Air Med J 2018 Jan - Feb;37(1):64-66. Epub 2017 Oct 20.
    Division of Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.
    Takotsubo syndrome is rare in pediatric patients but must be considered in patients with subarachnoid hemorrhage with pulmonary edema and cardiomyopathy. A systematic, collaborative approach is needed to facilitate emergent transfer of patients where extracorporeal cardiopulmonary resuscitation (e-CPR) is used as a lifesaving measure. Extracorporeal membrane oxygenation (ECMO) use in transport requires preplanning, role delineation, resources, and research efforts to be successful. Read More

    Cricothyrotomy in Helicopter Emergency Medical Service Transport.
    Air Med J 2018 Jan - Feb;37(1):51-53. Epub 2017 Dec 6.
    Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
    Objective: Airway management is a requisite skill set for helicopter emergency medical service (HEMS) providers. Cricothyrotomy is a potentially lifesaving skill that is used when other airway maneuvers fail. The authors reviewed all transports by a helicopter program in which cricothyrotomy was performed to assess the frequency, success, and technique. Read More

    Compliance With a National Standard by Norwegian Helicopter Emergency Physicians.
    Air Med J 2018 Jan - Feb;37(1):46-50. Epub 2017 Nov 29.
    Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
    Objective: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians.

    Methods: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire. Read More

    Development and Testing of a Neonatal Intubation Checklist for an Air Medical Transport Team.
    Air Med J 2018 Jan - Feb;37(1):41-45. Epub 2017 Nov 7.
    Airlift Northwest, Department of Pediatrics, Division of Neonatology, Seattle, WA.
    Objective: We developed a Neonatal Intubation Checklist for Airlift Northwest. Our goal was to improve the preparation, technical proficiency, and safety of neonatal intubation without increasing the time required to perform the procedure.

    Methods: The Neonatal Intubation Checklist, a "call and response" checklist for neonatal intubation, was developed. Read More

    An Analysis of Intoxicated Patients Transported by a Doctor Helicopter.
    Air Med J 2018 Jan - Feb;37(1):37-40. Epub 2017 Nov 6.
    Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan. Electronic address:
    Objective: We retrospectively investigated all of the intoxicated patients who were transported by a doctor helicopter (DH) in eastern Shizuoka between April 2004 and December 2015 to determine when air medical transport was used in cases of toxic exposure.

    Methods: Subjects were divided into 2 groups: an outpatient group of subjects who went home after receiving a medical evaluation and treatment and an admission group.

    Results: The outpatient and admission groups included 17 and 31 subjects, respectively. Read More

    Does Medical Staffing Influence Perceived Safety? An International Survey on Medical Crew Models in Helicopter Emergency Medical Services.
    Air Med J 2018 Jan - Feb;37(1):29-36. Epub 2017 Nov 1.
    Department of Health Studies, University of Stavanger, Stavanger, Norway; Department of Research and Development, The Norwegian Air Ambulance Foundation, Drøbak, Norway; Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
    Objective: The competence, composition, and number of crewmembers have generally been considered to influence the degree of patient care and safety in helicopter emergency medical services (HEMS), but evidence to support the advantages of one crew concept over another is ambiguous; additionally, the benefit of physicians as crewmembers is still highly debated.

    Methods: To compare perceived safety in different medical crew models, we surveyed international HEMS medical directors regarding the types of crew compositions their system currently used and their supportive rationales and to evaluate patient and flight safety within their services.

    Results: Perceived patient and flight safety is higher when HEMS is staffed with a dual medical crew in the cabin. Read More

    Retrospective Review of Pediatric Transport: Where Do Our Patients Go After Transport?
    Air Med J 2017 Nov - Dec;36(6):332-338. Epub 2017 Aug 12.
    Department of Pediatric Critical Care, Texas Children's Hospital, Houston, TX; Baylor College of Medicine, Houston, TX.
    Objective: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training.

    Methods: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Read More

    Air Medical-Evacuated Battle Injuries: French Army 2001 to 2014 in Afghanistan.
    Air Med J 2017 Nov - Dec;36(6):327-331. Epub 2017 Sep 15.
    French Armed Forces Research Institute, Paris, France.
    Objective: The purpose of strategic air medical evacuation (STRAT AE) is to enable the continuity of care and repatriation of wounded soldiers. Between 2001 and 2014, STRAT AEs have been implemented many times over the course of the military engagement in Afghanistan. The purpose of this work was to study the nature of the pathologies and the medicalization of patients most seriously wounded during the PAMIR Operation (Afghanistan). Read More

    Remote ECLS-Implantation and Transport for Retrieval of Cardiogenic Shock Patients.
    Air Med J 2017 Nov - Dec;36(6):320-326. Epub 2017 Aug 12.
    Department of Cardiac Surgery, University Hospital Munich, Ludwig-Maximilian-University, Marchioninistr. 15, 81377 Munich, Germany.
    Objective: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal. Read More

    Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval: A Retrospective Chart Review.
    Air Med J 2017 Nov - Dec;36(6):311-314. Epub 2017 Aug 12.
    School of Health, Medical & Applied Sciences, CQUniversity, Queensland, Australia.
    Objective: The aim of this study was to determine the prevalence, safety (as measured by the incidence of adverse events), and effectiveness (as measured by the incidence of intubations) of ketamine sedation in patients with acute behavioral disturbance (ABD) during air medical retrieval.

    Methods: This was a retrospective observational study. Eligible patients were identified by searching the electronic databases of 2 air medical retrieval services in Queensland, Australia, for adult patients with ABD transported between January 1, 2015, and June 30, 2016. Read More

    The Impact of Helicopter Emergency Medical Service Night Operations in South East England.
    Air Med J 2017 Nov - Dec;36(6):307-310. Epub 2017 Aug 14.
    Kent, Surrey and Sussex Air Ambulance Trust, Kent, UK; University of Surrey, Surrey, UK. Electronic address:
    Objective: This study sought to assess the impact of a helicopter emergency medical service (HEMS) capable of night operations.

    Methods: This is a retrospective case review of all night HEMS missions attended by a charity air ambulance service in South East England over a 2-year period (October 1, 2013, to October 1, 2015).

    Results: During the 2-year trial period, the HEMS service undertook a total of 5,004 missions and attended to 3,728 patients. Read More

    Prehospital Transfusion for Gastrointestinal Bleeding.
    Air Med J 2017 Nov - Dec;36(6):315-319. Epub 2017 Aug 2.
    Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN. Electronic address:
    Objective: Gastrointestinal (GI) bleeding is a common medical emergency with significant morbidity and mortality. Many patients are coagulopathic, which may perpetuate bleeding. Remote damage control resuscitation, including early correction of coagulopathy and anemia, may benefit exsanguinating patients with GI bleeding. Read More

    Temperature-sensitive Medications in Interfacility Transport: The Ice Pack Myth.
    Air Med J 2017 Nov - Dec;36(6):302-306. Epub 2017 Jul 29.
    Department of Pediatric Critical Care, Akron Children's Hospital, Akron, OH; Department of Pediatrics, Northeast Ohio Medical University, Rootstown, OH. Electronic address:
    Introduction: Critical Care Transport teams use various strategies to maintain temperature sensitive drugs and equipment at optimal temperature. The purpose of this study was to examine the effectiveness of current passive refrigeration of temperature sensitive transport medications/equipment.

    Methods: Initially, we performed a retrospective review of transport durations. Read More

    Hemodynamic Deterioration in Lateral Compression Pelvic Fracture After Prehospital Pelvic Circumferential Compression Device Application.
    Air Med J 2017 Sep - Oct;36(5):272-274. Epub 2017 Jul 6.
    CareFlight, Northmead, NSW, Australia.
    Increased fracture displacement has previously been described with the application of pelvic circumferential compression devices (PCCDs) in patients with lateral compression-type pelvic fracture. We describe the first reported case of hemodynamic deterioration temporally associated with the prehospital application of a PCCD in a patient with a complex acetabular fracture with medial displacement of the femoral head. Active hemorrhage from a site adjacent to the acetabular fracture was subsequently demonstrated on angiography. Read More

    Air Repatriation With a Medium-sized Pneumothorax Without Thoracic Tube: A Special Case of a Repatriation Accompanied by an Experienced Surgeon.
    Air Med J 2017 Sep - Oct;36(5):268-271. Epub 2017 Jun 22.
    Department of Trauma Surgery, University of Magdeburg, Magdeburg, Germany.
    We report on the repatriation of a 28-year old female from Germany, who was involved in a serious bus accident and was transported to the nearest hospital in Oruro, Bolivia. CT scans and x-rays performed in this hospital demonstrated a complete pneumothorax right. Thorax drainage was inserted, which was removed after 5 days. Read More

    Logistical Concerns for Prehospital Blood Product Use by Air Medical Services.
    Air Med J 2017 Sep - Oct;36(5):263-267. Epub 2017 Jun 21.
    University of Washington School of Medicine, Seattle, WA; Transfusion Service, Harborview Medical Center, Seattle, WA.
    Over the past few decades, reports have described favorable results from transfusion of blood products in helicopter EMS (HEMS). Nevertheless, the initiation of a HEMS transfusion program requires consideration of many factors, some unique to each clinical site. This paper describes our experience developing a HEMS transfusion program in an urban non-hospital based HEMS program with a history of long transport times. Read More

    Evaluation of Intensive Care Unit Ventilators at Altitude.
    Air Med J 2017 Sep - Oct;36(5):258-262. Epub 2017 Jun 17.
    Department of Surgery, University of Cincinnati, OH.
    Introduction: Devices may forgo US military air worthiness and safety testing in an attempt to expedite the availability of critical assets such as mechanical ventilators with a waiver for one-time use in extenuating circumstances.

    Methods: We evaluated two Intensive Care Unit (ICU) level ventilators: Drager Evita XL and Puritan Bennett (PB) 840 in an altitude chamber at sea level and altitudes of 8,000 and 16,000 feet.

    Results: Altitude affected delivered tidal volumes (VTs) in volume control mode (VCV) and Pressure Regulated Volume Controlled (PRVC) mode at altitude with the Evita XL but the differences were not considered clinically important with the PB 840. Read More

    Infusion Pump in UH60L/M Flight in Afghanistan: Why Failures Occur.
    Air Med J 2017 Sep - Oct;36(5):248-257. Epub 2017 May 26.
    MAJ, 7249th Medical Support Unit, United States Army Reserve, Houston, TX; Texas A&M College of Medicine, Bryan, TX.
    The ALARIS MSIII Infusion Pump (CareFusion, San Diego, CA) uses 3 separate alarms designed to prevent air emboli: "check air sensor," "air in lower tubing," and "air in line." It is assumed that ambient pressure changes cause air emboli that lead to pump failure although evidence to support this is limited. In this small study, the MSIII proved to be highly resilient and able to maintain function even after large repetitive emboli. Read More

    Reducing Door-in Door-out Intervals in Helicopter ST-segment Elevation Myocardial Infarction Interhospital Transfers.
    Air Med J 2017 Sep - Oct;36(5):244-247. Epub 2017 Jun 24.
    Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
    Background: Many health systems rely on helicopter EMS (HEMS) to transfer ST-elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI) to a hospital with a catheterization laboratory. Mortality rates increase with the time to reperfusion, so reducing delays is imperative. For interhospital STEMI transfers, the time spent in the initial hospital from arrival until departure (door-in to door-out interval or DIDO) should be minimized. Read More

    Development of a New Infusion Protocol for Austere Trauma Resuscitations.
    Air Med J 2017 Sep - Oct;36(5):239-243. Epub 2017 May 5.
    Emergency physician, certified flight paramedic, US Army flight surgeon, Landstuhl, Germany. Electronic address:
    Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. Read More

    Management of Mass Casualties Using Doctor Helicopters and Doctor Cars.
    Air Med J 2017 Jul - Aug;36(4):203-207. Epub 2017 Apr 6.
    At approximately 10 o'clock in September 2015, a minibus carrying 18 people accidentally slid backwards because of a malfunctioning brake system while climbing a steep incline on Togasayama Mountain, colliding with a van (Toyota HiAce wagon) carrying 11 people that was situated behind the minibus. Togasayama Mountain is located 1 hour by car and 10 minutes by helicopter from our hospital. The minibus slid off a roadside cliff at a height of 0. Read More

    The 5 T's: Applying Cognitive Science to Improve Prehospital Medical Education.
    Air Med J 2017 Jul - Aug;36(4):198-202. Epub 2017 Apr 5.
    Dartmouth Geisel School of Medicine and Dartmouth-Hitchcock Medicine Center.
    Although research on effective teaching methods exists, the application of this information in prehospital medical education is limited. Applying lessons from the realms of cognitive psychology and neuroscience, prehospital educators can enhance their ability to teach. One such concept is the theory of cognitive load. Read More

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