Air medical journal
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Air medical journal · Jan 2011
Case ReportsA 27-year-old man with multiple stab wounds to the chest.
A 27-year-old man presented to a community emergency department (ED) after sustaining multiple stab wounds to the anterior and posterior chest and posterior neck after an altercation at a local bar. Shortly after arrival at the ED, the patient's mental status altered, and he increasingly became combative and confused. When the patient was assessed in the ED, staff found the patient hypoxic with oxygen saturations noted to be in the low 90s. ⋯ Once his airway was controlled, he was placed on propofol for sedation and was pharmacologically paralyzed with pancuronium. His initial chest x-ray demonstrated bilateral pneumothoraces. Bilateral chest tubes were placed and arrangements made for transport by helicopter emergency medical services (EMS) to the nearest level 1 trauma center for continued management (Figure 1).
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Critical care transport (CCT) leaders and managers from 300 organizations were invited to participate in an online survey (participation rate, 34%) with approximately 150 questions covering a broad base of CCT organizational, workplace, personnel, and salary matters. In addition to medical team composition, recruitment and retention, training, education, and benefits, the survey presents CCT crew salary data by job class by Bowley's seven-figure summary, as well as average, minimum, and maximum hourly rates. Salaries are reported in a national aggregate and by Association of Air Medical Services region.
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The medical problems of the incarcerated population often require emergent transport to medical facilities via air or ground. The transport of this population, however, can be logistically challenging because of the potentially dangerous nature of the patients and requirements for accompanying security personnel. ⋯ Medical and traumatic problems of this transported population spanned a large variety of emergency complaints. Scene times reflected the nature of these transports and were not excessively long. Air medical programs should be aware of the medical problems of these patients and take measures to protect their crew when transporting this population.