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Aeromedical evacuation

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https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#1
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
#2
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/28470013/pyogenic-pericarditis-and-cardiac-tamponade-due-to-streptococcus-anginosus-in-a-combat-theater
#3
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-following-underbody-blast-induced-hyperacceleration
#4
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...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28291484/post-traumatic-stress-symptoms-in-united-states-air-force-aeromedical-evacuation-nurses-and-technicians
#5
Julie M Swearingen, Tanya M Goodman, Wayne L Chappelle, William T Thompson
Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291467/a-retrospective-cohort-analysis-of-battle-injury-versus-disease-non-battle-injury-two-validating-flight-surgeons-experience
#6
William P Butler, Lawrence W Steinkraus, Brittany L Fouts, Jennifer L Serres
Today, military combat medical care is the best it has ever been. Regulated U.S. Air Force aeromedical evacuation (AE) is one important reason. The Theater Validating Flight Surgeon (TVFS) validates that a patient is ready for flight. Two TVFSs' experiences, successively deployed in 2007, are the focus of this study. A unique operational worksheet used to manage the AE queue was used for approximately 5 months. A descriptive analysis of the worksheet's 1,389 patients found the majority male (94%), median age 30 years, and mostly Army enlisted soldiers (63%)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#7
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28094679/a-retrospective-analysis-of-a-pediatric-tele-echocardiography-service-to-treat-triage-and-reduce-trans-pacific-transport
#8
Christopher A Rouse, Brandon T Woods, C Becket Mahnke
Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28061918/clinical-experience-and-learning-style-of-flight-nurse-and-aeromedical-evacuation-technician-students
#9
Marla J De Jong, Susan F Dukes, Karey M Dufour, Darcy L Mortimer
BACKGROUND: The clinical experience and preferred learning style of U.S. Air Force flight nurses and aeromedical evacuation technicians are unknown. METHODS: Using a cross-sectional survey design, we gathered data regarding the clinical experience, level of comfort providing clinical care, and preferred learning style of 77 active duty (AD), Air Force Reserve (AFR), and Air National Guard (ANG) nurses enrolled in the U.S. Air Force School of Aerospace Medicine Flight Nurse course, and 121 AD, AFR, and ANG medical technicians enrolled in the Aeromedical Evacuation Technician course...
January 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/27903275/cell-cycle-inhibition-reduces-inflammatory-responses-neuronal-loss-and-cognitive-deficits-induced-by-hypobaria-exposure-following-traumatic-brain-injury
#10
Jacob W Skovira, Junfang Wu, Jessica J Matyas, Alok Kumar, Marie Hanscom, Shruti V Kabadi, Raymond Fang, Alan I Faden
BACKGROUND: Traumatic brain injury (TBI) patients in military settings can be exposed to prolonged periods of hypobaria (HB) during aeromedical evacuation. Hypobaric exposure, even with supplemental oxygen to prevent hypoxia, worsens outcome after experimental TBI, in part by increasing neuroinflammation. Cell cycle activation (CCA) after TBI has been implicated as a mechanism contributing to both post-traumatic cell death and neuroinflammation. Here, we examined whether hypobaric exposure in rats subjected to TBI increases CCA and microglial activation in the brain, as compared to TBI alone, and to evaluate the ability of a cyclin-dependent kinase (CDK) inhibitor (CR8) to reduce such changes and improve behavioral outcomes...
December 1, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27851515/1880-aeromedical-evacuation-from-a-combat-zone-expedited-ecmo-cannulation-via-the-transport-model
#11
James Lantry, Jeffrey DellaVolpe, Valerie Sams, Matthew Hamm, Philip Mason
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849490/the-psychological-effects-of-rapid-aeromedical-evacuation-in-a-predator-exposure-animal-model-of-post-traumatic-stress-disorder
#12
C Brad Wilson, Joseph Harre, Thomas Shaak, Joseph Francis, Leslie D McLaughlin
Recent conflicts have contributed to an escalation in combat-related psychiatric disorders, including post-traumatic stress disorder (PTSD). Although technological advances have increased the speed from which battlefield injuries reach definitive care, mental health conditions have continued to rise. This study sought to analyze the effects of flight stressors and the lack of a postcombat decompression period on stress-related behavior. We hypothesized that a 1-week decompression period before flight would attenuate stress-related behavior compared to no decompression...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27816610/forward-psychiatry%C3%A2-%C3%A2-early-intervention-for-mental-health-problems-among-uk-armed-forces-in-afghanistan
#13
N Jones, N T Fear, S Wessely, G Thandi, N Greenberg
BACKGROUND: This observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners. METHOD: In-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses...
November 3, 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/27753575/measuring-intangibles-defining-predictors-of-non-technical-skills-in-critical-care-air-transport-team-trainees
#14
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
https://www.readbyqxmd.com/read/27602899/automated-control-of-endotracheal-tube-cuff-pressure-during-simulated-flight
#15
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
https://www.readbyqxmd.com/read/27437912/decompressive-craniectomy-and-cranioplasty-experience-and-outcomes-in-deployed-uk-military-personnel
#16
S A G Roberts, E Toman, A Belli, M J Midwinter
OBJECT: In recent conflicts, many UK personnel sustained head injuries requiring damage-control surgery and aeromedical transfer to the UK. This study aims to examine indications, complications and outcomes of UK military casualties undergoing craniectomy and cranioplasty from conflicts in Afghanistan and Iraq. METHODS: The UK military Joint Theatre Trauma Registry (JTTR) was searched for all UK survivors in Afghanistan and Iraq between 2004 and 2014 requiring craniectomy and cranioplasty resulting from trauma...
October 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27215883/cardiovascular-complaints-among-military-members-during-operation-enduring-freedom
#17
James A Watts, Frank D Russo, Todd C Villines, Samuel O Jones, Gilberto Patino, Javed M Nasir, Robert E Eckart, Kevin E Steel
During Operation Enduring Freedom, the US military began deploying a dedicated theater cardiology consultant to Afghanistan in an effort to increase rates of return to duty in service members with cardiovascular complaints. This study was designed to categorize these complaints and determine the effect on both aeromedical evacuation and return to duty rates during a 2.5 year observation period. A total of 1,495 service members were evaluated, with 43% presenting due to chest pain followed by arrhythmias/palpitations (24...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27214588/responses-of-the-acutely-injured-spinal-cord-to-vibration-that-simulates-transport-in-helicopters-or-mine-resistant-ambush-protected-vehicles
#18
Femke Streijger, Jae H T Lee, Neda Manouchehri, Angela D Melnyk, Jason Chak, Seth Tigchelaar, Kitty So, Elena B Okon, Shudong Jiang, Rachel Kinsler, Khalid Barazanji, Peter A Cripton, Brian K Kwon
In the military environment, injured soldiers undergoing medical evacuation via helicopter or mine-resistant ambush-protected vehicle (MRAP) are subjected to vibration and shock inherent to the transport vehicle. We conducted the present study to assess the consequences of such vibration on the acutely injured spinal cord. We used a porcine model of spinal cord injury (SCI). After a T10 contusion-compression injury, animals were subjected to 1) no vibration (n = 7-8), 2) whole body vibration at frequencies and amplitudes simulating helicopter transport (n = 8), or 3) whole body vibration simulating ground transportation in an MRAP ambulance (n = 7)...
December 15, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27026118/complication-rates-in-altitude-restricted-patients-following-aeromedical-evacuation
#19
William P Butler, Lawrence W Steinkraus, Esther E Burlingame, Brittany L Fouts, Jennifer L Serres
INTRODUCTION: Military aeromedical evacuation, especially that associated with the present Middle East conflict, is seeing increasing research. This ecological study initiates research into the validating flight surgeon by looking at cabin altitude restriction (CAR), arguably the validating flight surgeon's prescription with the highest patient-mission impact, and its association with postflight complications. METHODS: CAR rates from January 2006 through February 2008 were determined from the U...
April 2016: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/26998778/brain-hypoxia-is-exacerbated-in-hypobaria-during-aeromedical-evacuation-in-swine-with-traumatic-brain-injury
#20
Anke H Scultetus, Ashraful Haque, Steve J Chun, Brittany Hazzard, Richard T Mahon, Martin J Harssema, Charles R Auker, Paula Moon-Massat, Debra L Malone, Richard M McCarron
BACKGROUND: There is inadequate information on the physiologic effects of aeromedical evacuation on wounded war fighters with traumatic brain injury (TBI). At altitudes of 8,000 ft, the inspired oxygen is lower than standard sea level values. In troops experiencing TBI, this reduced oxygen may worsen or cause secondary brain injury. We tested the hypothesis that the effects of prolonged aeromedical evacuation on critical neurophysiologic parameters (i.e., brain oxygenation [PbtO2]) of swine with a fluid percussion injury/TBI would be detrimental compared with ground (normobaric) transport...
July 2016: Journal of Trauma and Acute Care Surgery
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