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"Critical Care Air Transport Team"

Peter L Jernigan, Matthew C Wallace, Christine S Novak, Travis W Gerlach, Dennis J Hanseman, Timothy A Pritts, Bradley R Davis
BACKGROUND: Critical Care Air Transport Teams (CCATTs) are integral to the U.S. Air Force aeromedical evacuation paradigm. The current study was conducted to evaluate predictors of nontechnical skills (NOTECHS) in CCATT trainees. METHODS: Sixteen CCATTs were studied over a 6-month period. Team members completed a biographical survey and teams were videotaped during a simulated CCATT mission. Teams and individuals were assigned a "red flag score" using a validated assessment tool for NOTECHS...
October 2016: Military Medicine
Thomas Blakeman, Dario Rodriquez, James Woods, Daniel Cox, Joel Elterman, Richard Branson
BACKGROUND: Successful mechanical ventilation requires that the airway be controlled by an endotracheal tube (ETT) with an inflatable cuff to seal the airway. Aeromedical evacuation represents a unique challenge in which to manage ETT cuffs. We evaluated three methods of automatic ETT cuff pressure adjustment during changes in altitude in an altitude chamber. METHODS: Size 7.5 and 8.0 mm ETTs that are currently included in the Critical Care Air Transport Team allowance standard were used for the evaluation...
November 2016: Journal of Trauma and Acute Care Surgery
Alejandra G Mora, Victoria J Ganem, Alicia T Ervin, Joseph K Maddry, Vikhyat S Bebarta
INTRODUCTION: U.S. Critical Care Air Transport Teams (CCATTs) evacuate critically ill patients with acute pain in the combat setting. Limited data have been reported on analgesic administration en route, and no study has reported analgesic use by CCATTs. Our objective was to describe analgesics used by CCATTs for nonintubated, critically ill patients during evacuation from a combat setting. METHODS: We conducted an institutional review board-approved, retrospective review of CCATT records...
May 2016: Military Medicine
Ed Barnard, Alejandra G Mora, Vikhyat S Bebarta
BACKGROUND: There are no tools to predict outcomes in the U.S. Air Force Critical Care Air Transport Team (CCATT) trauma patients. The objective of this study was to identify associations between preflight variables and outcomes that could assist planning of ongoing critical care. METHODS: This Institutional Review Board approved retrospective study included all patients evacuated from Afghanistan by CCATT between 2007 and 2011. Preflight variables were assessed for associations and examined in logistic regression models...
May 2016: Military Medicine
Jay A Johannigman, David Zonies, Joseph Dubose, Thomas C Blakeman, Dennis Hanseman, Richard D Branson
OBJECTIVES: To determine the alterations in intracranial pressure (ICP) during U. S. Air Force Critical Care Air Transport Team transport of critically injured warriors with ICP monitoring by intraventricular catheter (IVC). METHODS: Patients with an IVC following traumatic brain injury requiring aeromedical evacuation from Bagram to Landstuhl Regional Medical Center were studied A data logger monitored both ICP and arterial blood pressure and was equipped with an integral XYZ accelerometer to monitor movement...
March 2015: Military Medicine
Joshua A Hamilton, Alejandra G Mora, Kevin K Chung, Vikhyat S Bebarta
BACKGROUND: US military Critical Care Air Transport Teams (CCATT) transport critically ill burn patients out of theater. Blood transfusion may incur adverse effects, and studies report lower hemoglobin (Hgb) value may be safe for critically ill patients. There are no studies evaluating the optimal Hgb value for critically ill burn patients prior to CCATT evacuation. OBJECTIVE: The aim of the study was to determine if critically ill burn casualties with an Hgb of 10 g/dL or less, transported via CCATT, have similar clinical outcomes at 30 days as compared with patients with an Hgb of greater than 10 g/dL...
August 2015: Shock
Alejandra G Mora, Alicia T Ervin, Victoria J Ganem, Vikhyat S Bebarta
BACKGROUND: Military critical care air transport teams (CCATT) evacuate critically ill and injured patients out of theater for tertiary treatment. Teams are led by a physician, nurse, and respiratory technician. Current aeromedical guidelines require a hemoglobin (Hgb) of 9 g/dL or greater to evacuate; however, civilians report that an Hgb of 8 g/dL or less is safe in critically ill patients. This study aimed to compare postflight short-term and 30-day patient outcomes for CCATT patients evacuated out of theater with an Hgb of 8 g/dL or less with those with an Hgb of greater than 8 g/dL...
November 2014: Journal of Trauma and Acute Care Surgery
Tyler Britton, Thomas C Blakeman, John Eggert, Dario Rodriquez, Heather Ortiz, Richard D Branson
BACKGROUND: Ascent to altitude results in the expansion of gases in closed spaces. The management of overinflation of the endotracheal tube (ETT) cuff at altitude is critical to prevent mucosal injury. METHODS: We continuously measured ETT cuff pressures during a Critical Care Air Transport Team training flight to 8,000-ft cabin pressure using four methods of cuff pressure management. ETTs were placed in a tracheal model, and mechanical ventilation was performed...
September 2014: Journal of Trauma and Acute Care Surgery
Bradley Davis, Katherine Welch, Sharon Walsh-Hart, Dennis Hanseman, Michael Petro, Travis Gerlach, Warren Dorlac, Jocelyn Collins, Timothy Pritts
BACKGROUND: Critical Care Air Transport Teams (CCATTs) are a critical component of the United States Air Force evacuation paradigm. This study was conducted to assess the incidence of task saturation in simulated CCATT missions and to determine if there are predictable performance domains. METHODS: Sixteen CCATTs were studied over a 6-month period. Performance was scored using a tool assessing eight domains of performance. Teams were also assessed during critical events to determine the presence or absence of task saturation and its impact on patient care...
August 2014: Military Medicine
Nichole Ingalls, David Zonies, Jeffrey A Bailey, Kathleen D Martin, Bart O Iddins, Paul K Carlton, Dennis Hanseman, Richard Branson, Warren Dorlac, Jay Johannigman
IMPORTANCE: Advances in the care of the injured patient are perhaps the only benefit of military conflict. One of the unique aspects of the military medical care system that emerged during Operation Iraqi Freedom and Operation Enduring Freedom has been the opportunity to apply existing civilian trauma system standards to the provision of combat casualty care across an evolving theater of operations. OBJECTIVES: To identify differences in mortality for soldiers undergoing early and rapid evacuation from the combat theater and to evaluate the capabilities of the Critical Care Air Transport Team (CCATT) and Joint Theater Trauma Registry databases to provide adequate data to support future initiatives for improvement of performance...
August 2014: JAMA Surgery
Samuel M Galvagno, Joseph J Dubose, Thomas E Grissom, Raymond Fang, Richard Smith, Vikhyat S Bebarta, Stacy Shackelford, Thomas M Scalea
Critical Care Air Transport Teams (CCATTs) have evolved as a vital component of the U.S. Air Force's aeromedical evacuation system. Previous epidemiological research in this area is limited. The objective of this commentary is to highlight the importance of obtaining robust epidemiological data regarding patients transported by CCATTs. A limited epidemiological analysis was performed to describe CCATT patients transported during Operation Enduring Freedom and the waning months of Operation Iraqi Freedom. CCATT transports for the calendar year 2011 were examined as recorded in the U...
June 2014: Military Medicine
Ismail Cicek, Jennifer L Serres
INTRODUCTION: The U.S. Air Force (USAF) School of Aerospace Medicine is conducting a fatigue research study titled "Assessment of Fatigue in Deployed Critical Care Air Transport Team (CCATT) Crews" using two electronic devices onboard USAF aircraft during actual CCATT missions. Both devices were subjected to testing to support a safe-to-fly (STF) recommendation prior to their use in flight. The purpose of the test and evaluation process was to ensure the devices can be safely operated in flight without posing a hazard to the research participant, crewmembers, or aircraft during an actual mission...
April 2014: Aviation, Space, and Environmental Medicine
Anthony P Tvaryanas, Genny M Maupin
BACKGROUND: This study investigated whether Critical Care Air Transport Team (CCATT) members are at increased risk for incident post-deployment mental health conditions. METHODS: We conducted a retrospective cohort study of 604 U.S. Air Force medical personnel without preexisting mental health conditions who had at least one deployment as a CCATT member during 2003-2012 as compared to a control group of 604 medical personnel, frequency matched based on job role, with at least one deployment during the same period, but without CCATT experience...
January 2014: Aviation, Space, and Environmental Medicine
Joshua D Gustafson, Sung Yang, Thomas Chris Blakeman, Warren C Dorlac, Richard Branson
BACKGROUND: Acute lung injury (ALI) is a condition that leads to impaired oxygen delivery. We demonstrated previously that using a portable oxygen concentrator (POC) with pulsed dose delivery of oxygen is an alternative option to conserve oxygen while still maintaining adequate oxygen delivery in a mechanical model. We hypothesized that using a modified POC, pulsed dose oxygen delivery can provide adequate oxygenation in an animal model. METHODS: In a crossover study, we induced ALI in 15 pigs using an oleic acid model...
October 2013: Journal of Trauma and Acute Care Surgery
Julio Lairet, James King, Leslie Vojta, William Beninati
PURPOSE: The purpose of this study is to describe the short-term outcomes (during air transport) of patients managed by the United States Air Force Critical Care Air Transport Teams (CCATT). METHODS: This is a retrospective chart review of patients who were transported by CCATT between March 1, 2007 and June 30, 2008. A standardized abstraction form was used. Patients were classified as medical or trauma. Care given inflight was documented, including mechanical ventilation, vasoactive medication administration, and administration of blood products...
October 2013: Prehospital Emergency Care
Josh Gustafson, Chris Blakeman, Warren Dorlac, Jay Johannigman, Richard Branson
SESSION TYPE: New Insights into ARDS/Lung InjuryPRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PMPURPOSE: Acute lung injury (ALI) is a common condition that leads to respiratory impairment with patients, specifically regarding oxygenation. Using a POC, it has been shown in a mechanical model that pulsed dose delivery of oxygen is an alternative to continuous oxygen flow in order to conserve oxygen, while still maintaining adequate oxygen delivery. We hypothesize that using a modified POC and pulsed dose oxygen delivery can be sufficient for ventilated patients, thus reducing oxygen requirements...
October 1, 2012: Chest
Joanne M Minnick, Vikhyat S Bebarta, Marietta Stanton, Julio R Lairet, James King, Pedro Torres, James Aden, Rosemarie Ramirez
INTRODUCTION: Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. METHODS: We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia...
November 2013: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Susan F Dukes, Elizabeth Bridges, Meg Johantgen
Traumatic brain injury patients are susceptible to secondary insults to the injured brain. A retrospective cohort study was conducted to describe the occurrence of secondary insults in 63 combat casualties with severe isolated traumatic brain injury who were transported by the U.S. Air Force Critical Care Air Transport Teams (CCATT) from 2003 through 2006. Data were obtained from the Wartime Critical Care Air Transport Database, which describes the patient's physiological state and care as they are transported across the continuum of care from the area of responsibility (Iraq/Afghanistan) to Germany and the United States...
January 2013: Military Medicine
Raymond Fang, Patrick F Allan, Shannon G Womble, Morris T Porter, Johana Sierra-Nunez, Richard S Russ, Gina R Dorlac, Clayne Benson, John S Oh, Sandra M Wanek, Erik C Osborn, Stephen V Silvey, Warren C Dorlac
BACKGROUND: The success of US Air Force Critical Care Air Transport Teams (CCATT) in transporting critically ill and injured patients enabled changes in military medical force deployment and casualty care practice. Even so, a subset of casualties remains who exceed even CCATT capabilities for movement. These patients led to the creation of the Landstuhl Acute Lung Rescue Team (ALeRT) to close the "care in the air" capability gap. METHODS: The ALeRT Registry was queried for the period between November 1, 2005, and June 30, 2010...
July 2011: Journal of Trauma
Theresa L Brewer, Nancy A Ryan-Wenger
The objective of this study was to use descriptive and phenomenological methods with Critical Care Air Transport Team (CCATT) nurses to identify knowledge and skills required to provide care for critically ill patients in a combat environment. Unstructured interviews, focus groups, written narratives, group interviews, participant observation, and review of in-flight documentation of care were used to obtain data from 23 registered nurses who had deployed with CCATT missions. Dimensions that emerged from the data included: clinical and operational competence, personal, physical, and psychosocial readiness, soldier and survival skills, leadership, administrative concerns, group identification and integration, aircraft air and evacuation familiarity, and nurse characteristics...
May 2009: Military Medicine
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