Air medical journal
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Air medical journal · Sep 2013
An investigation of pilot fatigue in helicopter emergency medical services.
Pilot error has caused the majority of helicopter emergency medical services (HEMS) accidents in the United States for almost 2 decades. Pilot fatigue may have contributed to some of these accidents. This nonexperimental quantitative study investigated the relationships between fatigue reported by on-duty HEMS pilots (the criterion variable) and consecutive HEMS pilot day shifts, consecutive HEMS pilot night shifts, age, and experience as an HEMS pilot (the predictor variables). ⋯ Multivariate regression analysis suggested that experience as an HEMS pilot predicted HEMS pilot night shift respondent BFI scores. Additional quantitative research is recommended to confirm the results of this study and to investigate relationships between fatigue experienced by HEMS pilots and other variables that were not considered in this investigation. Qualitative research to identify and document fatigue management strategies that are used by experience HEMS pilots is also recommended.
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Air medical journal · Sep 2013
Critical care transportation by paramedics: a cross-sectional survey.
The purpose of this study was to gather data from paramedics practicing in the critical care transport setting to guide development of the education, training, and clinical practices for certification as a critical care paramedic. ⋯ Paramedics reported being the primary provider on the critical care transport team and performing skills while using equipment and administering medications that exceeded their education and training as paramedic and, at times, without the benefit of any additional education or training. National appreciation of this reality should spur development of standardized education, licensing or certification, and continuing education to prepare paramedics for their role as critical care medical providers.
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Air medical journal · Sep 2013
Prehospital use of tranexamic acid for hemorrhagic shock in primary and secondary air medical evacuation.
Major hemorrhage remains a leading cause of death in both military and civilian trauma. We report the use of tranexamic acid (TXA) as part of a trauma exanguination/massive transfusion protocol in the management of hemorrhagic shock in a civilian primary and secondary air medical evacuation (AME) helicopter EMS program. ⋯ We report the successful integration of TXA into a primary and secondary AME program in the setting of major trauma with confirmed or suspected hemorrhagic shock. Further studies are needed to assess the effect of such a protocol in this patient population.
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Air medical journal · Sep 2013
ReviewCommercial air travel after pneumothorax: a review of the literature.
Because of the physiological stresses of commercial air travel, the presence of a pneumothorax has long been felt to be an absolute contraindication to flight. Additionally, most medical societies recommend that patients wait at least 2 weeks after radiographic resolution of the pneumothorax before they attempt to travel in a nonurgent fashion via commercial air transport. ⋯ We have made recommendations, when possible, addressing the nonurgent commercial air travel for the patient with a recent pneumothorax. However, more scientific research is necessary in order to reach an evidence-based conclusion on pneumothoraces and flying.