Air medical journal
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Air medical journal · Nov 1994
Comparative StudyUse of a pulse oximeter for determination of systolic blood pressure in a helicopter air ambulance.
Traditional methods of determining blood pressure may be unreliable (auscultation or palpation) or unavailable (direct arterial cannulation) in the air medical environment. The authors investigated the combination of a pulse oximeter with a standard sphygmomanometer (blood pressure) cuff as an alternative method. ⋯ The obliteration of the wave form display on a pulse oximeter is an accurate, convenient, inexpensive and readily available alternative method of determining SBP.
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Air medical journal · Nov 1994
Comparative StudyAnalysis of intubations. Before and after establishment of a rapid sequence intubation protocol for air medical use.
After finding the success rate of intubations in our air medical program to be less than optimal (with a success rate of only 73%), a protocol for increased doses of sedatives and neuromuscular blocking (NMB) agents was developed for field use by flight nurses and paramedics. ⋯ Our results suggest that protocols including sedatives and NMB agents can be used safely and effectively by an appropriately trained air medical team of nurses and paramedics and may improve patient care.
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The American Society for Testing Materials (ASTM) F-30 Committee on Emergency Medical Services (EMS) began creating voluntary consensus standards for EMS including air medical transport in 1984. The F-30 Committee is composed of more than 200 members who represent both the "producers" and the "users" of EMS. Approximately 10 of the 39 standards published by the F-30 Committee either deal directly or indirectly with air medical programs. ⋯ Air medical programs may participate as members of the F-30 Committee for a nominal yearly fee, which provides members with an updated book of standards. Meetings are held biannually. The Guide for Establishing the Qualifications, Education and Training of EMS Aeromedical Patient Care Providers is approaching its four-year review, and a number of other standards, which are of particular interest to the air medical community, are currently under development.
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Air medical journal · Aug 1994
Comparative StudyIs oral endotracheal intubation efficacy impaired in the helicopter environment?
Patients transported by helicopter often require advanced airway management. The purpose of this study was to determine whether or not the in-flight environment of air medical transport in a BO-105 helicopter impairs the ability of flight nurses to perform oral endotracheal intubation. ⋯ Oral endotracheal intubation in the in-flight setting of the BO-105 helicopter takes approximately twice as long as intubation in a ground setting. The results support pre-flight intubation of patients who appear likely to require urgent intubation during air medical transport in the BO-105 helicopter.
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With pending changes in the health-care system, there are increasing pressures for each aspect of health care to justify its use. Several organizations, including the Association of Air Medical Services (AAMS), have published position papers listing appropriate indications for air medical services. Additionally, the Commission on Accreditation of Air Medical Services (CAAMS) specifies that air medical services monitor their flights for appropriateness. The purpose of this study was to determine how often the air medical transports by this program met at least one of the AAMS criteria. ⋯ The AAMS "Appropriate Use of Air Medical Services" position paper provides a foundation to monitor the utilization of an air medical transport program, which can be used to meet both government payer requirements for justification and the CAAMS requirement for utilization review.