Air medical journal
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Our rural trauma center uses packed red blood cells (PRBCs) and plasma onboard our helicopter to offset the delay of transport. We summarize our initial experience with prehospital blood use in pediatric trauma patients. ⋯ Prehospital use of blood in injured children is rare. However, when indicated, this initial review of our protocol showed increased hemoglobin, decreased acidosis, and unexpected survivors with our program. Because of the rarity of prehospital blood use in children, administration triggers require continued review and refinement.
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Air medical journal · Jan 2015
Rural trauma patients cannot wait: tranexamic Acid administration by helicopter emergency medical services.
Tranexamic acid (TXA) administration has been shown to reduce mortality in bleeding trauma patients if given in the hospital within 3 hours of injury. Its use has been theorized to be of benefit in the prehospital environment. This study evaluates the timing of TXA administration in a critical care helicopter emergency medical service (HEMS) versus that of the destination trauma hospital. ⋯ TXA must be administered before arrival at a trauma hospital to meet the recommendation of administration within 3 hours of injury for all patients transferred between facilities and for many patients transported from a trauma scene.
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Air medical journal · Jan 2015
Factors associated with mode of transport decision making for pediatric-neonatal interfacility transport.
Transport professionals must routinely engage in complex decision making. One challenging decision is the determination of mode of transport. This study explores the decisional factors involved in the determination of mobilizing ground ambulance versus helicopter for pediatric-neonatal interfacility transport. The aim was to gather initial qualitative data to aid in the development of an objective scoring tool that would be used to guide the mode of transport decision for pediatric and neonatal interfacility transport. The focus of the study was to elicit the factors that influence the mode of transport decision among professionals who are involved in this decision. ⋯ Health care providers responsible for directing and conducting the interfacility transport of critically ill children are more likely to mobilize a helicopter for transport in the face of neurovascular or respiratory clinical concerns in conjunction with a prolonged transport distance. When the provider's level of concern is lower, then a ground ambulance is consistently chosen even if out of hospital time is prolonged.