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"Critical Care Transport"

Michael T Bigham, Richard J Brilli
No abstract text is available yet for this article.
October 2016: Pediatric Critical Care Medicine
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
Atsushi Kawaguchi, Anna Gunz, Allan de Caen
OBJECTIVES: This study aimed to better understand the unique aspects of pediatric critical care transport programs across Canada by characterizing the current workforce of each transport program. METHODS: A cross-sectional questionnaire was sent to the 13 medical directors of Canada's pediatric critical care transport teams, and to 2 nonhospital-affiliated transport services. If a children's hospital did not have a dedicated team for pediatric transport, the regional transport team providing this service was identified...
August 20, 2016: Pediatric Emergency Care
Jeffrey M Singh, Anna C Gunz, Sonny Dhanani, Mahvareh Aghari, Russell D MacDonald
OBJECTIVES: Transport of pediatric patients is common due to healthcare regionalization. We set out to determine the frequency of in-transit critical events during pediatric critical care transport and identify factors associated with these events. DESIGN: Retrospective cohort study using administrative and clinical data. SETTING: Single pediatric critical care transport provider in Ontario, Canada. PATIENTS: All pediatric care transports between January 1, 2005, and December 31, 2010...
October 2016: Pediatric Critical Care Medicine
Jorge Mena-Munoz, Udayan Srivastava, Christian Martin-Gill, Brian Suffoletto, Clifton W Callaway, Francis X Guyette
BACKGROUND: Civilian out-of-hospital transfusions have not been adequately studied. This study seeks to characterize patients receiving out-of-hospital blood product transfusion during critical care transport. STUDY DESIGN AND METHODS: We studied patients transported by a regional critical care air-medical service who received blood products during transport. This service carries two units of uncrossmatched packed Red Blood Cells (pRBCs) on every transport in addition to blood obtained from referring facilities...
September 2016: Prehospital Emergency Care
Russell D MacDonald, Felipe Allendes
OBJECTIVE: Transport of intra-aortic balloon pump (IABP)-dependent patients between hospitals is increasingly common. The transports are typically time-sensitive and require personnel familiar with IABP operation and management of a potentially unstable patient. This study examined transports performed by specially trained critical care paramedics in a large air medical and land critical care transport service. METHODS: This retrospective, descriptive review prospectively collected data for IABP-dependent patient transports in Ontario, Canada in a 10-year interval beginning September 2003...
July 2016: Air Medical Journal
Celeste M Alfes, Stephanie Steiner, Tonya Rutherford-Hemming
OBJECTIVE: The purpose of this study was to identify the challenges new crewmembers experience in the critical care transport (CCT) environment and to determine the most valuable resources when acclimating to the transport environment. To date, no study has focused on the unique challenges nor the resources most effective in CCT training. METHODS: This descriptive exploratory study was conducted with a convenience survey sent to the 3 largest professional CCT organizations: the Association of Air Medical Services, the Air and Surface Transport Nurses Association, and the Association of Critical Care Transport...
July 2016: Air Medical Journal
Susan R Wilcox, Mark S Saia, Heather Waden, Michael Frakes, Suzanne K Wedel, Jeremy B Richards
OBJECTIVE: Although the benefit of transferring patients with hypoxemic respiratory failure to tertiary care centers has been shown, transporting hypoxemic patients remains controversial, given the risk of desaturation in transit. METHODS: We performed a retrospective analysis of a database of critical care transports (CCTs) of patients with hypoxemic respiratory failure to quantify the number, types, and effects of ventilator changes performed by the CCT teams...
May 2016: Air Medical Journal
Michele L Kuszajewski, John M O'Donnell, Paul E Phrampus, Walter C Robey, Patricia K Tuite
OBJECTIVE: Airway assessment and management are vital skills for the critical care transport provider. Nurses and paramedics often enter a transport program with limited or no exposure to airway management. Many programs lack a structured curriculum to show skill competence. Optimal methods in the development of airway management competence and the frequency of training needed to maintain skills have not been clearly defined. Because of this lack of standardization, the actual level of competence in both new and experienced critical care transport providers is unknown...
May 2016: Air Medical Journal
Cornelius A Thiels, Johnathon M Aho, Aoidhnait S Fahy, Maile E Parker, Amy E Glasgow, Kathleen S Berns, Elizabeth B Habermann, Scott P Zietlow, Martin D Zielinski
INTRODUCTION: Despite advances in trauma care, hemorrhage continues to be the leading cause of preventable mortality in trauma. The evidence to support its use in non-trauma patients is limited. We aim to report our experience with prehospital blood product transfusion. We hypothesize that it is safe, appropriately utilized, and that our protocol, which was designed for trauma patients, is adaptable to fit the needs of non-trauma patients. METHODS: Patients transfused with blood products, packed red blood cells (pRBCs) or plasma, in the prehospital environment between 2002 and 2014 were included...
October 2016: World Journal of Surgery
Neil B Davids
Over the past 14 years of conflict, the Department of Defense medical community has made significant strides in patient care. As the conflicts developed, many sources identified a critical gap in en route care, specifically the need for critical care trained personnel for point of injury and intrahospital transfers, as well as improved outcomes for patients who received care from critical care trained providers. As stopgap measures were implemented, the US Army instituted the Critical Care Flight Paramedic Program in order to meet this need of life saving critical care transport...
April 2016: U.S. Army Medical Department Journal
Erik Jan van Lieshout, Jan Binnekade, Elmer Reussien, Dave Dongelmans, Nicole P Juffermans, Rob J de Haan, Marcus J Schultz, Margreeth B Vroom
PURPOSE: Regionalization and concentration of critical care increases the need for interhospital transport. However, optimal staffing of ground critical care transport has not been evaluated. METHODS: In this prospective, randomized, open-label, blinded-endpoint non-inferiority trial, critically ill patients on mechanical ventilation transported by interhospital ground critical care transport were randomized between transport staffed by a dedicated team comprising a critical care nurse and paramedic (nurses group) or a dedicated team including a critical care physician (nurses + physician group)...
July 2016: Intensive Care Medicine
Celeste M Alfes, Amanda S Rowe
The Dorothy Ebersbach Academic Center for Flight Nursing in Cleveland, OH, holds an annual flight camp designed for master's degree nursing students in the acute care nurse practitioner program, subspecializing in flight nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University. The weeklong interprofessional training is also open to any health care provider working in an acute care setting and focuses on critical care updates, trauma, and emergency care within the critical care transport environment...
March 2016: Air Medical Journal
Susan R Wilcox, Mark S Saia, Heather Waden, Susan J McGahn, Michael Frakes, Suzanne K Wedel, Jeremy B Richards
UNLABELLED: Introduction Inter-facility transport of critically ill patients is associated with a high risk of adverse events, and critical care transport (CCT) teams may spend considerable time at sending institutions preparing patients for transport. The effect of mode of transport and distance to be traveled on on-scene times (OSTs) has not been well-described. Problem Quantification of the time required to package patients and complete CCTs based on mode of transport and distance between facilities is important for hospitals and CCT teams to allocate resources effectively...
June 2016: Prehospital and Disaster Medicine
Susan R Wilcox, Mark S Saia, Heather Waden, Alissa Genthon, Jonathan D Gates, Michael N Cocchi, Susan J McGahn, Michael Frakes, Suzanne K Wedel, Jeremy B Richards
OBJECTIVE: The purpose of this study is to measure the rate and magnitude of changes in oxygenation that occur in patients with hypoxemic respiratory failure after transport by a critical care transport team. METHODS: We performed a retrospective review of 239 transports of patients with hypoxemic respiratory failure requiring a fraction of inspired oxygen (Fio2) > 50% transported from October 2009 to December 2012 from referring hospitals to 3 tertiary care hospitals...
November 2015: Air Medical Journal
Felix Oberender
No abstract text is available yet for this article.
October 2015: Pediatric Critical Care Medicine
Joshua M Tobin, Giles R Nordmann, Eric J Kuncir
OBJECTIVE: These data describe the critical care procedures performed on, and the resuscitation markers of, critically wounded personnel in Afghanistan following point of injury (POI) transports and intratheater transports. Providing this information may help inform discussion on the design of critical care transportation platforms for future conflicts. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried for descriptive data on combat casualties with Injury Severity Score (ISS) greater than 15 who were transported in Operation Enduring Freedom (OEF) from 1 January 2010 to 31 December 2010...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Celeste M Alfes, Stephanie L Steiner, Christopher F Manacci
The air medical transport arena requires the practitioner to develop clinical and diagnostic reasoning abilities to manage the dynamic needs of the patient in unstructured, uncertain, and often unforgiving environments. High-fidelity simulation can be instrumental in training interprofessional flight teams to improve competency through quality and safe patient care during medical transport that may otherwise take years to learn because of the inconsistency in real-world experiences. Because of the suboptimal circumstantial conditions inherent to critical care transport, a helicopter simulator designed to discretely replicate the phases of flight and train teams in air medical transport scenarios has been developed at the Dorothy Ebersbach Academic Center for Flight Nursing at the Frances Payne Bolton School of Nursing in Cleveland, OH...
July 2015: Air Medical Journal
Hamilton P Schwartz, Michael T Bigham, Pamela J Schoettker, Keith Meyer, Michael S Trautman, Robert M Insoft
OBJECTIVES: The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics...
October 2015: Pediatric Critical Care Medicine
Susan R Wilcox, Mark S Saia, Heather Waden, Susan J McGahn, Michael Frakes, Suzanne K Wedel, Jeremy B Richards
INTRODUCTION: Critical care transport (CCT) teams must manage a wide array of medications before and during transport. Appreciating the medications required for transport impacts formulary development as well as staff education and training. Problem As there are few data describing the patterns of medication administration, this study quantifies medication administrations and patterns in a series of adult CCTs. METHODS: This was a retrospective review of medication administration during CCTs of patients with severe hypoxemic respiratory failure from October 2009 through December 2012 from referring hospitals to three tertiary care hospitals...
August 2015: Prehospital and Disaster Medicine
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