Air medical journal
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Air medical journal · Jul 2018
Helicopter Transportation Increases Intracranial Pressure: a Proof-of-Principle Study.
After severe (primary) brain injury, Dutch physician-based helicopter emergency medical services start therapy to lower the intracranial pressure (ICP) on scene to stop or delay secondary brain injury. In some cases, helicopter transportation to the nearest level 1 trauma center is indicated. During transportation, the head-down position may counteract the ICP-lowering strategies because of venous blood pooling in the head. To examine this theory, we measured the optic nerve sheath diameter (ONSD) during helicopter transport in healthy volunteers. ⋯ ONSD and ICP seem to increase during helicopter transportation in -9° head-down (Trendelenburg) position. By raising the headrest of the gurney before liftoff, these effects can be prevented.
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Air medical journal · Jul 2018
Comparative StudyPreliminary Report: Comparing Aspiration Rates between Prehospital Patients Managed with Extraglottic Airway Devices and Endotracheal Intubation.
There has been a shift from endotracheal intubation (ETI) toward extraglottic devices (EGDs) for prehospital airway management. A concern exists that this may lead to more frequent cases of aspiration. ⋯ In this small quality assurance database, aspiration rates were not significantly different for prehospital patients managed with an EGD versus ETI.
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Air medical journal · Jul 2018
ReviewSetting the Benchmark for the Ground and Air Medical Quality in Transport International Quality Improvement Collaborative.
Critical care transport (CCT) supports regionalization of medical care. Focus on the quality of CCT care prompted the development of the Ground and Air Medical qUality in Transport (GAMUT) Quality Improvement collaborative database which tracks consensus quality metrics. The Institute of Medicine recommends benchmarking of comparative data to accelerate improvement. Herein, we report the strategies and rationale for GAMUT QI Collaborative benchmarking. ⋯ Benchmarking is not well-suited for a single strategy and requires customized consideration based on each metric, though adjusted benchmark and ABC generally set higher performance benchmarks.
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Air medical journal · May 2018
The Effect of Team Configuration on the Incidence of Adverse Events in Pediatric Critical Care Transport.
Specialty pediatric transport teams are widely used for pediatric interfacility transport in the United States, with little industry consensus on optimal team configuration. The aim of this study is to assess the quality of the nurse/paramedic specialty team configuration as indirectly measured by the rate of adverse events in these transports. ⋯ There was no significant difference in the rate of adverse event occurrence in nurse/paramedic team configurations versus nurse/nurse configuration. Using critical care paramedics on pediatric transport teams enables a larger volume of patients to be transported to definitive care without concerns for decrease in quality or safety.
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Air medical journal · May 2018
Comparative StudyComparing the Efficacy of Methods for Immobilizing the Thoracic-Lumbar Spine.
The purpose of this study was to compare the relative efficacy of immobilization systems in limiting thoracic-lumbar movements. ⋯ Under the study conditions, the vacuum mattress was more effective for limiting involuntary movements of the thoracic-lumbar region than the long spine board. Moreover, the increased lateral bend observed with the long spine board under some conditions suggests it may be inadequate for immobilizing this anatomic region as presently designed. Should emergency medical service providers choose to immobilize patients with suspected injuries of the thoracic-lumbar spine, study results support the use of the vacuum mattress.