Air medical journal
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The purpose of this study was to describe the roles, levels of responsibility and backgrounds of flight nurses employed in flight programs across the country and to determine if the role of the flight nurse varied as a function of crew configuration or size of program. ⋯ Flight nurses practice in advanced autonomous roles, performing duties and skills consistent with critical care and emergency medicine in air medical transport.
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Air medical journal · Oct 1995
The effectiveness of esophageal stethoscopy in a simulated in-flight setting.
Previous research has confirmed the inability of flight nurses in an airborne BO-105 helicopter to hear breath sounds using normal or amplified transthoracic stethoscopy. The purpose of this study was to determine whether esophageal stethoscopy enabled effective auscultation of breath sounds in a simulated in-flight environment. ⋯ In the simulated environment tested, esophageal stethoscopy enabled 100% accuracy in identification of breath sounds, as compared with previously reported 0% efficacy for standard transthoracic auscultation. Study in the actual patient-care environment is indicated to confirm the usefulness of esophageal stethoscopy in the in-flight setting.
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Air medical journal · Jul 1995
Comparative StudyAnalysis of prehospital pediatric and adult intubation.
Pediatric airway control, including endotracheal intubation (ETI), presents a clinical challenge in the prehospital setting. Endotracheal intubation is recommended for serious head injury (Glasgow Coma Scale score <=8). We evaluated the frequency of ETI in pediatric and adult patients with <=8 in the field, subsequently transported by a hospital-based, helicopter emergency medical service (HHEMS). ⋯ Pediatric coma patients were not intubated with the same frequency as adults. This discrepancy between groups was secondary to a higher failure rate in the pediatric group. Intubation was attempted in 92% of pediatric patients versus 84% of the adults. Unsuccessful intubation attempts in the pediatric group, 20 of 58 (34%), were compared with 29 of 296 (9.8%) in the adult group. Difficulty in pediatric airway control may require an increased level of training and experience.
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Quality assurance (QA) and continuous quality improvement (CQI) are valued activities within health-care organizations. Quality assurance indicators as guidelines for quality practice usually are established intuitively. The purpose of this study was to determine an appropriate threshold for successful intubation in patients transported by air and to examine factors impacting this success rate. ⋯ Factors impacting successful intubation include cardiac arrest, use of neuromuscular blockade, use of sedatives and facial trauma. Data from the study support a threshold for successful intubation of between 90% and 95%.
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This survey attempts to identify the current standard of care for the air medical transport of the patient in cardiopulmonary arrest. ⋯ This study provides some insight on the current air medical management of the patient in cardiopulmonary arrest. National practice guidelines should be developed and tested prospectively in future studies.