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Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Yukihisa Sanada, Tadashi Orita, Tatsuo Torii
Aerial radiological survey using an unmanned aerial vehicle (UAV) was applied to measurement surface contamination around the Fukushima Daiichi nuclear power station (FDNPS). An unmanned helicopter monitoring system (UHMS) was developed to survey the environmental effect of radioactive cesium scattered as a result of the FDNPS accident. The UHMS was used to monitor the area surrounding the FDNPS six times from 2012 to 2015. Quantitative changes in the radioactivity distribution trend were revealed from the results of these monitoring runs...
October 3, 2016: Applied Radiation and Isotopes
Dominic Way, Hortense Blazsin, Ragnar Löfstedt, Frederic Bouder
This paper reviews the main tools for communicating benefit-risk medicines information to patients that are used, or could be used, by pharmaceutical regulators. One highly successful tool from the food safety sector (front-of-package traffic-light labelling) and the mental models approach (which provides a framework for developing new tools) are also reviewed as they show great promise for being usefully adapted to the pharmaceutical context. The evolution of benefit-risk medicines communication is first contextualised within the broader risk communication literature...
October 14, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Tia Renouf, Megan Pollard
Rural and remote places like Sable Island (Nova Scotia) or François (Newfoundland) pose a challenge in delivering both health care and appropriate education that today's learners need to practice in a rural setting. This education can be difficult to deliver to students far from academic centers. This is especially true for learners and practitioners at offshore locations like ships, oil installations, or in the air when patients are transported via fixed wing aircraft or helicopter. The following editorial provides a snapshot of the setting and the challenges faced while working as a physician on a ship, in remote regions...
September 9, 2016: Curēus
Linda Sandström, Carina Nilsson, Päivi Juuso, Åsa Engström
INTRODUCTION: When emergency medical services (EMS) are needed, the choice of transport depends on several factors. These may include the patient's medical condition, transport accessibility to the accident site and the receiving hospital's resources. Emergency care research is advancing, but little is known about the patient's perspective of helicopter emergency medical services (HEMS). AIM: The aim of this study was to describe trauma patients' experiences of HEMS...
September 30, 2016: International Emergency Nursing
Eilif Dahl
A previously healthy 65-year-old female passenger presented on the 3rd day of her voyage with a small facial laceration after she fell and hit her forehead, following sudden blurred vision and dizziness. When the ship's doctor noticed that one pupil was much bigger than the other, he feared intracranial bleeding and considered helicopter evacuation. Her symptoms had started shortly after she had removed a transdermal scopolamine patch from behind her ear. Getting scopolamine from her hands in direct contact with the eye surface caused mydriasis...
2016: International Maritime Health
Arne Tribukait, Eddie Bergsten, Ola Eiken
BACKGROUND: During hovering with a helicopter, an involuntary change in attitude (during brownout) results in reduced lifting force and a horizontal acceleration component. This movement pattern is difficult to perceive via the otolith organs. If the angular displacement occurs rapidly, it will, however, activate the semicircular canals. The major aim of this study was to establish to what extent pitch-plane angular displacements can be perceived based on canal information when there is no tilt stimulus to the otoliths...
2016: Aerospace Medicine and Human Performance
Xianfeng Yang, Zhiqiang Zhang, Jialing Yang, Yuxin Sun
The crashworthiness of helicopter fuel tank is vital to the survivability of the passengers and structures. In order to understand and improve the crashworthiness of the soft fuel tank of helicopter during the crash, this paper investigated the dynamic behavior of the nylon woven fabric composite fuel tank striking on the ground. A fluid-structure interaction finite element model of the fuel tank based on the arbitrary Lagrangian-Eulerian method was constructed to elucidate the dynamic failure behavior. The drop impact tests were conducted to validate the accuracy of the numerical simulation...
2016: SpringerPlus
Julia Ausserer, Elizabeth Moritz, Matthias Stroehle, Hermann Brugger, Giacomo Strapazzon, Simon Rauch, Peter Mair
INTRODUCTION: In remote and mountainous areas, helicopter emergency medical systems (HEMS) are used to expedite evacuation and provide pre-hospital advanced trauma life support (ATLS) in major trauma victims. Aim of the study was to investigate feasibility of ATLS in HEMS mountain rescue missions and its influence on patient condition at hospital admission. PATIENTS: 58 major trauma victims (Injury Severity Score ≥16), evacuated by physician staffed HEMS from remote and mountainous areas in the State of Tyrol, Austria between 1...
September 8, 2016: Injury
Patrick Schober, Herman M T Christiaans, Stephan A Loer, Lothar A Schwarte
OBJECTIVE: Safety in helicopter emergency medical services (HEMS) settings might be enhanced by the routine use of portable multigas analyzers to indicate hypoxic ambient air mixtures and the presence of hazardous gases. METHODS: In our HEMS (EC-135, Lifeliner 1, Amsterdam, The Netherlands), we introduced a professional multigas analyzer (Gas Alert Max XT II; Honeywell Analytics, Lincolnshire, IL) to prospectively detect possible hazardous gas mixtures. This analyzer measures ambient oxygen percentage (FO2, 0%-30%), carbon monoxide (CO, 0-1,000 ppm), hydrogen sulfide (H2S, 0-200 ppm), and combustibles (lower explosive limit, %)...
September 2016: Air Medical Journal
Urs Pietsch, Jürgen Knapp, Ludwig Ney, Armin Berner, Volker Lischke
OBJECTIVE: Mountain helicopter rescue operations often confront crews with unique challenges in which even minor errors can result in dangerous situations. Simulation training provides a promising tool to train the management of complex multidisciplinary settings, thus reducing the occurrence of fatal errors and increasing the safety for both the patient and the helicopter emergency medical service (HEMS) crew. METHODS: A simulation-based training, dedicated to mountain helicopter emergency medicine service, was developed and executed...
September 2016: Air Medical Journal
Cristian Abelairas-Gómez, Pablo Vázquez-González, Sergio López-García, José Palacios-Aguilar, Alexis Padrón-Cabo, Antonio Rodríguez-Núñez
OBJECTIVE: Our objective was to assess the cardiopulmonary resuscitation (CPR) quality by helicopter rescue swimmers (HRSs) while flying. METHODS: Twenty HRSs from the Spanish Maritime Safety took part in this study. The research protocol included 2 phases: a baseline test (5 minutes of CPR on land) and a challenge test (5 minutes of CPR on a Sikorsky S-61N helicopter in-flight). A Laerdal Resusci Anne mannequin with Laerdal PC Skill Reporting (Stavanger, Norway) was used to register CPR variables...
September 2016: Air Medical Journal
Jessie Biles, Alan A Garner
INTRODUCTION: Although harness suspension trauma has been documented since the 1960s, especially in the mountaineering setting, there is little robust medical research into the area. Helicopter hoist rescue shares similar risks and is reserved for those cases that cannot be accessed safely by other routes, where extrication may be hazardous or will take an unreasonable amount of time. The single sling or chest harness used for hoist rescue is a single harness around the upper torso and is easier and quicker to apply than a stretcher...
September 2016: Aerospace Medicine and Human Performance
Nicole Powell-Dunford, Jose F Quesada, Kirby R Gross, Stacy A Shackelford
BACKGROUND: Identify challenges and best practices in the development of an austere air ambulance transfusion program. METHODS: A search of PubMed using combinations of the key terms 'prehospital,' 'blood product,' 'red blood cells,' 'damage control resuscitation,' 'transfusion,' 'air ambulance,' 'medical evacuation,' and 'medevac' yielded 196 articles for further analysis, with 14 articles suitable for addressing the background of prehospital transfusion within a helicopter...
August 2016: Aerospace Medicine and Human Performance
Kenneth E Games, Joni M Lakin, John C Quindry, Wendi H Weimar, JoEllen M Sefton
INTRODUCTION: Despite significant investment into the development and improvement of military helicopter seat systems, military aviators continue to report seat system related pain and discomfort during prolonged missions. METHODS: Using a factorial repeated measures design, 15 healthy subjects completed the study, in which focal pressure was applied to two locations on the sitting surfaces of the body (ischial tuberosity and middle of the posterior thigh). Pressure was applied using a purpose-built pressure application system allowing subjects to sit in a position mimicking the sitting position in the UH-60 Black Hawk helicopter...
August 2016: Aerospace Medicine and Human Performance
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Susan R Wilcox, Michael Ries, Ted A Bouthiller, E Dean Berry, Travis L Dowdy, Sharon DeGrace
Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team...
September 13, 2016: Journal of Intensive Care Medicine
Ragnar Glomseth, Fritz I Gulbrandsen, Knut Fredriksen
BACKGROUND: Search and rescue (SAR) operations constitute a significant proportion of Norwegian ambulance helicopter missions, and they may limit the service's capacity for medical operations. We compared the relative contribution of the different helicopter resources using a common definition of SAR-operation in order to investigate how the SAR workload had changed over the last years. METHODS: We searched the mission databases at the relevant SAR and helicopter emergency medical service (HEMS) bases and the Joint Rescue Coordination Centre (North) for helicopter-supported SAR operations within the potential operation area of the Tromsø HEMS base in 2000-2010...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ciaran S Hill, Aaron L McLean, Mark H Wilson
OBJECTIVE: Pediatric traumatic brain injury is the most common cause of death and a major cause of morbidity in children and young adults worldwide. Despite this, our understanding of epidemiological factors relating to this type of injury is incomplete. The objective of this study was to explore a variety of factors relating to these injuries including mechanism, timing of emergency response, prehospital management, radiological diagnosis, neurosurgical care, and final outcomes. METHODS: A retrospective review of all pediatric traumas attending a single large, densely populated urban area within a 2-year period was undertaken, and all cases with significant pediatric traumatic brain injury, as defined by a computed tomography scan showing an intracranial injury, were included for further analysis...
September 9, 2016: Pediatric Emergency Care
Andrzej Skowron, Andrzej Jankowski
Understanding the nature of interactions is regarded as one of the biggest challenges in projects related to complex adaptive systems. We discuss foundations for interactive computations in interactive intelligent systems (IIS), developed in the Wistech program and used for modeling complex systems. We emphasize the key role of risk management in problem solving by IIS. The considerations are based on experience gained in real-life projects concerning, e.g., medical diagnosis and therapy support, control of an unmanned helicopter, fraud detection algorithmic trading or fire commander decision support...
2016: Natural Computing
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