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Aeromedical

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https://www.readbyqxmd.com/read/28985859/in-by-helicopter-out-by-cab-the-financial-cost-of-aeromedical-overtriage-of-trauma-patients
#1
SriGita Krishna Madiraju, Joseph Catino, Candace Kokaram, Thomas Genuit, Marko Bukur
BACKGROUND: Helicopter transport of injured patients is controversial and costly. This study aims to show that a complex trauma algorithm leads to significant aeromedical overtriage at substantial cost. Our secondary outcomes were to compare adjusted mortality and outcomes between air and ground transport and determine predictors of overtriage. MATERIALS AND METHODS: A 6-y retrospective analysis was conducted of all trauma activations at a Level I center. Patients were dichotomized by transportation method as well as trauma activation criteria...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28923146/cannon-ball-diagnosis-and-management-in-a-flight-attendant-candidate
#2
Meryem Zerrik, Houda Echchachoui, Zakaria Iloughmane, Choukri El'mhadi, Salaheddine Elkhader, Laila Benaissa, Mohamed Chemsi
BACKGROUND: ''Cannon ball'' opacities on chest X-rays are a common manifestation of hematogenous dissemination of a malignant tumor in the lungs. They indicate an advanced stage of disease with a very grim prognosis in terms of cure and survival. In aerospace medicine, this aspect means the patient is unfit for flight duties. Nonmetastatic etiologies of pulmonary nodules are rare. We report a case of cannon ball opacities discovered fortuitously during an admission visit. CASE REPORT: A 23-yr-old flight attendant candidate came to the Aeromedical Expertise Center of the Military Hospital in Rabat for medical evaluation...
October 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28923140/working-memory-capacity-and-surgical-performance-while-exposed-to-mild-hypoxic-hypoxemia
#3
Paul J Parker, Andrew J Manley, Ross Shand, John P O'Hara, Adrian Mellor
INTRODUCTION: Medical Emergency Response Team (MERT) helicopters fly at altitudes of 3000 m in Afghanistan (9843 ft). Civilian hospitals and disaster-relief surgical teams may have to operate at such altitudes or even higher. Mild hypoxia has been seen to affect the performance of novel tasks at flight levels as low as 5000 ft. Aeromedical teams frequently work in unpressurized environments; it is important to understand the implications of this mild hypoxia and investigate whether supplementary oxygen systems are required for some or all of the team members...
October 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28835512/non-battle-injury-among-repatriated-uk-armed-forces-since-cessation-of-combat-operations-a-prospective-observational-study
#4
Emma Toman, A Beaven, D N Naumann, R W Myatt, P J Parker, A R Kay
AIM: To describe the mechanisms, burden of injury, inpatient management and rehabilitation requirements of wounded military personnel at the UK Role 4 (R4) facility within the first 12 months following cessation of combat operations in Afghanistan. METHODS: All aeromedical evacuations were recorded prospectively between October 2014 and October 2015. Demographic, logistical and clinical data were derived manually from referring medical unit and patient movement requests in addition to host nation and R4 medical records...
August 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28818147/attention-deficit-hyperactivity-disorder-and-fatal-accidents-in-aviation-medicine
#5
Tanja Laukkala, Robert Bor, Bruce Budowle, Antti Sajantila, Pooshan Navathe, Markku Sainio, Alpo Vuorio
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms of inattention and/or hyperactivity-impulsivity that interfere with functioning and/or development. ADHD occurs in about 2.5% of adults. ADHD can be an excluding medical condition among pilots due to the risk of attentional degradation and therefore impact on flight safety. Diagnosis of ADHD is complex, which complicates aeromedical assessment. This study highlights fatal accident cases among pilots with ADHD and discusses protocols to detect its presence to help to assess its importance to flight safety...
September 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28746084/epidemiology-and-location-of-primary-retrieval-missions-in-a-scottish-aeromedical-service
#6
Gregg Neagle, Lisa Curatolo, John Ferris, Mike Donald, Stephen Hearns, Alasdair R Corfield
INTRODUCTION: Prehospital critical care teams comprising an appropriately trained physician and paramedic or nurse have been associated with improved outcomes in selected trauma patients. These teams are a scarce and expensive resource, especially when delivered by rotary air assets. The optimal tasking of prehospital critical care teams is therefore vital and remains a subject of debate. Emergency Medical Retrieval Service (EMRS) provides a prehospital critical care response team to incidents over a large area of Scotland either by air or by road...
July 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28720188/the-importance-of-the-study-of-cognitive-performance-enhancement-for-u-s-national-security
#7
REVIEW
Richard G Malish
The American military is embarking on the 'Third Offset'-a strategy designed to produce seismic shifts in the future of warfare. Central to the approach is the conjoining of humans, technology, and machines to deliver a decisive advantage on the battlefield. Because technology will spread rapidly and globally, tactical overmatch will occur when American operators possess a competitive edge in cognition. Investigation of cognitive enhancing therapeutics is not widely articulated as an adjunct to the Third Offset, yet failure to study promising agents could represent a strategic vulnerability...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#8
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719431/bispectral-index-measurements-are-not-degraded-during-aeromedical-evacuations
#9
Nicolas Donat, Audrey Cirodde, Clément Hoffmann, Jean-Vivien Schaal, Yannick Masson, Antoine Nau, Paul Vincent Martin, Samuel Madec, Thomas Leclerc
For a decade, depth of anesthesia monitoring has become a reality in the operating room. It provides valuable help for managing anesthesia, especially for unstable patients. This might be particularly relevant during aeromedical evacuation. In this study, we aimed to assess the validity of the bispectral index (BIS) during long-range patient transportation aboard fixed-wing aircraft. BIS was recorded in 30 patients, 25 under anesthesia and 5 awake, during aeromedical evacuations performed by the French Air Force...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28657244/emergency-aeromedical-services-in-ireland-a-single-centre-study-in-2014
#10
G A Sheridan, D Cooper, J P Gibbons, O Breathnach, J F Quinlan
This retrospective analysis includes patients requiring Emergency Aeromedical Services (EAS) in 2014. The aim of this paper is to evaluate the HEMS service in a single centre and to accurately assess whether certain internationally validated criteria can predict admission rates better than the currently used criteria. Using the American College of Surgeons (ACS) trauma-related dispatch criteria, each case was retrospectively evaluated. Results showed the mean total criteria met were 2.73 (?=0.88) and 1.45 (?=0...
March 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28641679/normobaric-hypoxia-and-submaximal-exercise-effects-on-running-memory-and-mood-state-in-women
#11
Yongsuk Seo, Hayden D Gerhart, Jon Stavres, Curtis Fennell, Shane Draper, Ellen L Glickman
BACKGROUND: An acute bout of exercise can improve cognitive function in normoxic and hypoxic conditions. However, limited research supports the improvement of cognitive function and mood state in women. The purpose of this study was to examine the effects of hypoxia and exercise on working memory and mood state in women. METHODS: There were 15 healthy women (age = 22 ± 2 yr) who completed the Automated Neuropsychological Assessment Metrics-4th Edition (ANAM), including the Running Memory Continuous Performance Task (RMCPT) and Total Mood Disturbance (TMD) in normoxia (21% O2), at rest in normoxia and hypoxia (12...
July 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28630743/comparison-of-five-video-assisted-intubation-devices-by-novice-and-expert-laryngoscopists-for-use-in-the-aeromedical-evacuation-environment
#12
Matthew C Wallace, SSgt Tyler Britton, Robbie Meek, Sharon Walsh-Hart, Col Todd E Carter, Steven J Lisco
BACKGROUND: The critically ill or injured patient undergoing military medical evacuation may require emergent intubation. Intubation may be life-saving, but it carries risks. The novice or infrequent laryngoscopist has a distinct disadvantage because experience is critical for the rapid and safe establishment of a secured airway. This challenge is compounded by the austere environment of the back of an aircraft under blackout conditions. This study determined which of five different video-assisted intubation devices (VAIDs) was best suited for in-flight use by U...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28570350/impact-of-critical-care-air-transport-team-ccatt-ventilator-management-on-combat-mortality
#13
Joseph K Maddry, Alejandra G Mora, Shelia C Savell, Crystal A Perez, Phillip E Mason, James K Aden, Vikhyat S Bebarta
BACKGROUND: Aeromedical evacuation platforms such as Critical Care Air Transport Teams (CCATTs) play a vital role in the transport and care of critically injured and ill patients in the combat theater. Mechanical ventilation is used to support patients with failing respiratory function and patients requiring high levels of sedation. Mechanical ventilation, if not managed appropriately, can worsen or cause lung injury, as well as contribute to increased morbidity.The purpose of this study was to evaluate the impact of ARDSNet protocol compliance during aeromedical evacuation of ventilated combat injured patients...
May 30, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28539156/early-human-factors-studies-for-spaceflight-at-the-aeromedical-field-laboratory-at-holloman-air-force-base
#14
Loretta Hall
No abstract text is available yet for this article.
June 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#15
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28518007/patient-centric-side-effect-risk-assessment-for-medications-used-during-aeromedical-evacuations
#16
Shana A Huntsberger, William P Butler, Richard R Chapleau
BACKGROUND: The U.S. Air Force performs more than 6000 aeromedical transport flights annually, both internationally and domestically. Many of these flights include patients requiring pain relief medications. The risk of side effects from such medications administered at altitude is unknown, but understanding these risks is vital when selecting the safest pain management strategies to achieve optimal postflight outcomes. METHODS: Using an evidence-based medication side effect risk assessment model, we compared our patient-centric approach to an aircrew-centric approach using medications approved for use in U...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28518005/safety-considerations-for-medical-staff-and-patients-who-fly-over-water-in-a-helicopter-for-work-or-recreation
#17
Christopher J Brooks, Conor V MacDonald
BACKGROUND: Around 25% of people involved in a helicopter accident in water do not survive. From time to time, physicians and their medical staff are required to fly over water in a helicopter to attend one or more seriously ill patients. Many will have had little or no experience of the issues involved if the helicopter has an accident in the water. Also as Family Practitioners, Aeromedical Examiners, and Flight Surgeons, they are asked to provide advice to patients, travel agents, and airline booking agents about whether an overwater helicopter flight is advisable or not...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#18
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28470013/pyogenic-pericarditis-and-cardiac-tamponade-due-to-streptococcus-anginosus-in-a-combat-theater
#19
Ryan C Maves, Michael S Tripp, Tracy Franzos, Scott C Wallace, Benjamin J Drinkwine, Todd C Villines
Streptococcus anginosus group pericarditis is rare. A 24-year-old male soldier presented for care at a military clinic in Afghanistan with shock and cardiac tamponade requiring emergent pericardial drainage and aeromedical evacuation. We review the patient's case, the need for serial pericardial drainage, and the available literature on this disorder.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28452879/aeromedical-evacuation-relevant-hypobaria-worsens-axonal-and-neurologic-injury-in-rats-after-underbody-blast-induced-hyperacceleration
#20
Julie L Proctor, Kaitlin T Mello, Raymond Fang, Adam C Puche, Robert E Rosenthal, William L Fourney, Ulrich H Leiste, Gary Fiskum
BACKGROUND: Occupants of military vehicles targeted by explosive devices often suffer from traumatic brain injury (TBI) and are typically transported by the aeromedical evacuation (AE) system to a military medical center within a few days. This study tested the hypothesis that exposure of rats to AE-relevant hypobaria worsens cerebral axonal injury and neurologic impairment caused by underbody blasts. METHODS: Anesthetized adult male rats were secured within cylinders attached to a metal plate, simulating the hull of an armored vehicle...
July 2017: Journal of Trauma and Acute Care Surgery
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