Air medical journal
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Air medical journal · Nov 2021
Feasibility of Prehospital Emergency Anesthesia in the Cabin of an AW169 Helicopter Wearing Personal Protective Equipment During Coronavirus Disease 2019.
Prehospital emergency anesthesia in the form of rapid sequence intubation (RSI) is a critical intervention delivered by advanced prehospital critical care teams. Our previous simulation study determined the feasibility of in-aircraft RSI. We now examine whether this feasibility is preserved in a simulated setting when clinicians wear personal protective equipment (PPE) for aerosol-generating procedures (AGPs) for in-aircraft, on-the-ground RSI. ⋯ In-aircraft RSI (aircraft on the ground) while wearing PPE for AGPs had no significant impact on the time to successful completion of ETI in a simulated setting. Patient safety is paramount in civilian helicopter emergency medical services, but the adoption of in-aircraft RSI could confer significant patient benefit in terms of prehospital time savings, and further research is warranted.
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Air medical journal · Nov 2021
Direct Versus Video Laryngoscopy in a Helicopter Emergency Medical Services Setting: A Retrospective Comparison.
Since the introduction of video laryngoscopy (VL) as a technique for orotracheal intubation, its use has become widespread among prehospital providers. However, little information is available about the efficacy and success of VL compared with direct laryngoscopy (DL) in the helicopter emergency medical services (HEMS) setting. The objective of this study was to investigate whether VL or DL increased successful first-pass orotracheal intubations and overall intubation success by HEMS providers. ⋯ No statistically significant difference was found in the first-pass rate, the overall success rate, or complications between DL and VL.
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Air medical journal · Jul 2021
Rural and Remote Intubations in an Australian Air Medical Retrieval Service: A Retrospective Cohort Study.
Critically unwell patients in rural and remote areas of Queensland, Australia, often require airway management with rapid sequence intubation before retrieval to a tertiary center. Retrieval Services Queensland coordinate retrievals and support rural hospitals, including via telehealth. This study compared the demographics of patients intubated by a retrieval team including a LifeFlight Retrieval Medicine doctor with those intubated by the local hospital team. ⋯ A retrieval team is more likely to intubate patients in remote hospitals in Queensland, Australia. Remote hospitals should be given preference for dispatch of the retrieval team for assistance with critical patients.
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Air medical journal · May 2021
Observational StudyCardiac Arrest in Flight: A Retrospective Chart Review of 92 Patients Transported by a Critical Care Air Medical Service.
The purpose of this study was to describe the incidence, characteristics, and outcomes of cardiac arrest in the air medical environment so that we can begin to understand predictors of in-flight cardiac arrest and identify opportunities to improve care. ⋯ Cardiac arrest during air medical transport is a rare event that requires a high level of critical care to treat refractory cardiac arrests, hemodynamic instability, and airway compromise.
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Air medical journal · May 2021
Determining a Need for Point-of-Care Ultrasound in Helicopter Emergency Medical Services Transport.
Point-of care-ultrasound (PoCUS) is useful in evaluating unstable emergency department patients. The portability of this technology increases its potential use in prehospital settings, including helicopter emergency medical services (HEMS) programs. Identifying useful applications may support implementing a PoCUS program that develops sonography skills for prehospital providers. The aim of this study was to determine the HEMS patient population that would benefit from prehospital PoCUS for hypotension and how commonly the extended focused assessment with sonography in trauma (E-FAST) for trauma patients or the rapid ultrasound in shock (RUSH) for medical patients could be used by HEMS. ⋯ Fifty percent of HEMS patients may benefit from PoCUS to evaluate for hypotension in flight.