Air medical journal
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Air medical journal · Jan 2007
Sidestream end-tidal carbon dioxide monitoring during helicopter transport.
End-tidal carbon dioxide (EtCO(2)) monitoring is standard of care for intubated patients. Sidestream technology also allows EtCO(2) monitoring in non-intubated patients. This is the first study to evaluate the feasibility of monitoring sidestream EtCO(2) on intubated and non-intubated patients during helicopter transport. ⋯ Sidestream EtCO(2) monitoring is feasible during air medical transport of both intubated and non-intubated patients. The mechanism was easy to use, and consistent numeric values and waveforms with alveolar plateaus were obtained in a large majority of readings.
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Air medical journal · Jan 2007
Medically appropriate use of helicopter EMS: the mission acceptance/triage process.
Appropriate use of helicopter emergency medical services (HEMS) ensures the maximum impact of a limited resource on improved health outcomes. Overtriage increases real and opportunity costs and may unjustifiably expose the program to small but inherent safety risks. The purpose of this study is to describe the mission acceptance process for an integrated, provincially based HEMS program and determine its utilization patterns. ⋯ The rate of medically appropriate missions in this system is relatively high. Prospective research is required to improve HEMS triage systems.
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Air medical journal · Jan 2007
Sleep debt and outside employment patterns in helicopter air medical staff working 24-hour shifts.
Twenty-four hour availability creates physiological and psychological challenges for air medical teams. The 24-hour shift (24H) is a common staffing pattern in the air medical community. We report sleep dept and pre-duty activity patterns for 24H medical staff members at helicopter air medical transport programs. ⋯ In the programs surveyed, 24H crewmembers completed an average duty cycle with little sleep debt and were unlikely to be sleepless prior to reporting for a shift. OE is common for 24H medical staff and some personnel report for flight duty within eight hours of leaving an OE position. As the industry considers the impact of fatigue on operational safety, shift length, on-duty rest, and outside employment will be important considerations.
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Air medical journal · Nov 2006
Analysis of 2004 German general aviation aircraft accidents according to the HFACS model.
The number of aircraft accidents remains on a constant level since the late 1990s. Routine analysis in detail of the causative factors is not carried out in Germany. The analysis of flight mishaps has been demonstrated to be an important basis for flight safety. The Human Factors Analysis and Classification System (HFACS) model is best suitable for aircraft accident analysis. The aim of this study was to classify aircraft accidents in the General Aviation (GA) of Germany according to the HFACS model and to figure out the underlying causes. ⋯ Our data mainly seem to be in concordance with previously published data on GA. An improvement of flight safety can be achieved only with a detailed analysis of the accident data. Therefore, more data on aircraft accidents in Germany are needed, for example, by adapting the German aircraft accident report form. Pilots should train in approaches and landings to conduct a higher level of proficiency.
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Air medical journal · Nov 2006
Feasibility of preclinical cardiac output and systemic vascular resistance in HEMS in thoracic pain--the ultrasonic cardiac output monitor.
Cardiac output (CO) and systemic vascular resistance (SVR) are important hemodynamic parameters in emergency patients and for clinical early goal-directed therapy. This study evaluated the feasibility of CO and SVR determination using preclinical continuous wave Doppler ultrasound in a helicopter emergency medical service (HEMS) on emergency patients presenting with or without thoracic pain as a pilot observational study. ⋯ Determining SV, CO/CI, and SVR in different emergency situations in HEMS using rapid CW Doppler ultrasound is feasible. Thoracic pain patients have increased SVR and lower CO/CI and reduced aortic minute distance than do non-thoracic pain patients in the preclinical setting.