Air medical journal
-
Air medical journal · Jul 2004
Comparative StudyAir medical transport of severely head-injured patients undergoing paramedic rapid sequence intubation.
The San Diego Paramedic Rapid Sequence Intubation (RSI) Trial documented an increase in mortality with paramedic RSI of patients with severe traumatic brain injury. This analysis explores the impact of air medical transport of trial patients on outcome. ⋯ Air medical transport of severely head-injured patients undergoing paramedic RSI was associated with improved outcomes. Improved ventilation by capnometry may account for part of these improvements.
-
A recent study in the Journal of Neurosurgery demonstrates decreased mortality rates in patients with subarachnoid hemorrhage (SAH) treated at tertiary care centers with higher volumes of SAH patients.(1) As clinical research in emergency and critical care increases, so will its impact on transport systems. In recent years, advances in cardiology, interventional radiology, surgery, and emergency care all have had major influences in the triage and transport of critically ill and injured patients. ⋯ It discusses the transition from initial research and national recommendations for emergent thrombolytic therapy through the development and implementation of prehospital triage protocols. The authors hope it will offer some guidance in dealing with these rapidly emerging and often complicated transport decisions.
-
Air medical journal · May 2004
Comparative StudyImpact of a triage tool on air versus ground transport of cardiac patients to a tertiary center.
The optimum method of transport for acute cardiac patients remains controversial. We proposed a physician-developed triage scheme for appropriate use of air versus mobile intensive care unit (ICU) in the transfer of cardiac patients and sought to determine the impact on the distribution of transport mode for cardiac patients in areas of personal characteristics and clinical factors and whether the triage scheme would be a valuable decision-making tool for physicians referring cardiac patients to tertiary centers. ⋯ A physician-developed triage instrument to select an appropriate mode of transport for acute cardiac transfers was effectively used. Further studies must validate the cardiac triage criteria against clinical outcomes, and more effective dissemination of the triage instrument must be sought. Furthermore, this information must be perceived as useful by referring physicians to gain wider acceptance.
-
Air medical journal · Mar 2004
Long-distance transport of ventilated patients: advantages and limitations of air medical repatriation on commercial airlines.
To illustrate the advantages and limitations of transporting ventilated intensive care unit patients over intercontinental distances on commercial airlines, this case series reports 8 ventilated patients repatriated by an air medical transport company. ⋯ Long distance international transport of ventilated intensive care unit patients is an extremely cost intensive and logistically challenging task. In a certain subgroup of relatively stable ventilated patients, transport on commercial airlines offers advantages in terms of cost effectiveness and reduced transport time and acceleration/deceleration trauma as a result of multiple fuel stops.