The Journal of air medical transport
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A 5-year retrospective review of airway management by flight nurses was conducted to evaluate airway care and to determine the frequency of surgical cricothyrotomy. Intubation was attempted in 51% of patients, with a success rate of 80%. ⋯ Overall, 87% of patients were successfully intubated and surgical cricothyrotomy was required in only one patient. A greater success rate was achieved when intubations were performed before takeoff than during flight.
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Patients flown on air medical aircraft are separated from family and other concerned parties, often for several hours and many miles. This paper studies the usefulness and safety of offering transport to these passengers on air medical aircraft. A nine-item questionnaire was mailed to 95 program directors. ⋯ From these responses it was concluded that more than half of all helicopter programs can carry a patient's family, but do so only 5% of the time. All fixed-wing programs can carry family of patients and do so from 35% to 95% of the time. Various benefits and disadvantages were discovered, analyzed, and discussed.
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Neuromuscular blocking agents (NMBs) are frequently used to facilitate intubations in the hospital. The 1987 membership of the Association of Air Medical Services (AAMS) was surveyed to determine the frequency of NMB use by flight programs both before and after definitive airway control. Out of 141 programs, 101 returned completed survey forms. ⋯ The presence of a physician on the flight crew was associated with the use of succinylcholine prior to definitive airway control. Reported complications included three deaths attributed to use of NMBs in the preceding two years. We conclude that NMBs are commonly used following intubation, and that NMBs are used before intubation by some flight programs, especially those that have physician crew members.