"Aeromedical"

INTRODUCTION: Aboriginal and Torres Strait Islander Peoples (First Nations Australians) living in remote communities are hospitalised with skin and soft tissue infections (SSTIs) at three times the rate of non-First Nations Australians. The Torres Strait in tropical northern Australia has a highly dispersed population mainly comprising First Nations Australians. This study aimed to define the health service utilisation and health system costs associated with SSTIs in the Torres Strait and to improve the quality of regional healthcare delivery...

OBJECTIVE: To define the utility of the Triage Revised Trauma Score (TRTS), GCS/Age/arterial Pressure (GAP) score, and shock index (SI) in predicting the need for in-flight blood product administration in civilian trauma patients transported by an aeromedical platform. METHODS: A retrospective chart review of 3582 aeromedical trauma cases was conducted. An initial TRTS, GAP score and SI were calculated for each patient, and the administration of in-flight blood products was also recorded...

INTRODUCTION: In order to improve rural and austere trauma care, hospital-based testing performed at the point of injury may shorten the time lapsed from injury to intervention. This study aimed to evaluate the use of the TEG6s® device in a rotary wing aircraft. Prior attempts suffered from limitation related to lack of vibration mitigation. METHODS: This was an investigator initiated, industry supported study. Haemonetics® provided a TEG6s® analyzer...

INTRODUCTION: Aeromedical evacuations from the past few decades have yielded massive amounts of data that may inform the Military Health System (MHS) on patient needs, specifically for understanding the inpatient and outpatient needs of evacuees. In this study, we evaluate inpatient and outpatient trends based on aeromedical evacuation data from recent conflicts. We anticipate that evacuations requiring MHS inpatient beds are primarily trauma-related and necessitate an increased need for inpatient trauma care...

OBJECTIVE: Ventilator-assisted preoxygenation (VAPOX) is a method of preoxygenation and apnoeic ventilation which has been tried in hospital setting. We aimed to describe VAPOX during intubation of critically unwell patients in aeromedical retrieval setting. METHODS: Retrospective observational study of VAPOX performed at LifeFlight Retrieval Medicine (LRM) between January 2018 and December 2022 across Queensland, Australia. Demographic and clinical data were recorded...

OBJECTIVE: Desaturation during prehospital rapid sequence intubation (RSI) is common and is associated with patient morbidity. Past studies have identified oxygen saturations at induction, the grade of laryngoscopy, and multiple attempts to intubate as being associated with desaturation. This study aimed to investigate whether there are other factors, identifiable before RSI, associated with desaturation. METHODS: This was a study of a physician-paramedic critical care team operating as Aeromedical Operations, NSW Ambulance...

INTRODUCTION: Coronary artery disease (CAD) is a cause of death in 75% of patients with diabetes. Its often asymptomatic nature delays diagnosis. In aeronautics, it can cause in-flight incapacitation, beyond which it represents a major fear for the medical expert. Screening for CAD is still a topical subject with the advent of new cardiovascular (CV) risk biomarkers and more effective screening tests. We report the experience of the Aeromedical Expertise Center of Rabat in this screening of diabetic pilots, with a recommendations review...

INTRODUCTION: U.S. Army aviators are required to maintain a level of physiological fitness as part of their qualifying process, which suggests that they are generally physically healthy. However, it has not been statistically proven that they are more "physiologically fit" than the general population. METHODS: This retrospective study compares physiological measurements of U.S. Army aviators from the Aeromedical Electronic Resource Office database to the U.S. general population using the Center for Disease Control's National Health and Nutrition Examination Survey data...

In Pittsburgh, Pennsylvania, the skies have become a battleground against time in a world where every second counts. Since its inception in 1978, a revolution has occurred in emergency medical services, with LifeFlight Helicopters soaring to new heights in emergency treatment and transport. This article will explore the transformation of helicopter emergency medical services through the decades, where every rotor blade spins with a mission to save lives and rewrite the rules of survival. Allegheny Health Network's LifeFlight is a rotor-wing (helicopter) aeromedical transport service that provides rapid emergent transport for critically ill and injured persons...

Treatment of high altitude pulmonary edema (HAPE) can be challenging and is further complicated in the pediatric patient in the prehospital environment. The following case presents a decompensating pediatric patient with HAPE in the prehospital aeromedical environment. It illustrates the potential benefit of continuous positive airway pressure (CPAP) as a treatment modality in the treatment of HAPE.

High blood pressure is a major cardiovascular risk factor closely linked to serious cardiovascular events. A real public health problem affecting more than one in three adults. Aircrew does not escape this pathology, despite very strict medical selection and rigorous and regular medical monitoring by the aircrew doctor during revision visits. We conducted a retrospective study at the medical expertise center for aircrew in Rabat which made it possible to collect 34 hypertensive civilian aircrew for 10 years, from January 2012 to December 2022...

INTRODUCTION: Work-related stress is common in pilots, with broad implications, including the potential development of mental health symptoms and sometimes even psychiatric disease. This commentary argues for the use of narrative as a tool to promote preventive health behaviors in pilots and combat misinformation about aeromedical certification related to mental health. Hoffman WR, McNeil M, Tvaryanas A. The untapped potential of narrative as a tool in aviation mental health and certification . Aerosp Med Hum Perform...

BACKGROUND: With the advancement of medicine and the development of technology, the limiting factors of aeromedical evacuation are gradually decreasing, and the scope of indications is expanding. However, the hypobaric and hypoxic environments experienced by critically ill patients in flight can cause lung injury, leading to inflammation and hypoxemia, which remains one of the few limiting factors for air medical evacuation. This study aimed to examine the mechanism of secondary lung injury in rat models of acute lung injury that simulate aeromedical evacuation...

Musculoskeletal pain can be a significant safety risk to aircrew. Flight surgeons are the primary care providers for aircrew and are responsible for safely treating musculoskeletal pain. Certain medical interventions can be used to treat pain while maintaining the ability to fly safely. A previous F-18 Naval Flight Officer presented to the flight surgeon with chronic neck pain seeking noninvasive and nonpharmacological therapy. After one Osteopathic Manual Treatment session using the Fascial Distortion Model (FDM), the patient had improved pain and function...

As reported in the 2022 Biden-Harris National Security Strategy, China is perceived as the primary U.S. competitor with the intent and means to become the world's greatest superpower. China's efforts, which are at odds with America's ambition to maintain its global influence, are complemented by ostensibly harmless "gray zone tactics," defined as coercive geopolitical, economic, military, and cyber activities below the use of kinetic military force. Such tactics may be utilized with seemingly innocuous intentions, but in reality, they can complicate U...

INTRODUCTION: In remote Australian hospitals there are no onsite paediatric intensive care units (PICUs), increasing the reliance on aeromedical retrieval to access tertiary care. Nasal high flow (NHF) therapy is an oxygen therapy used in tertiary hospitals to treat paediatric patients with respiratory conditions. In rural and remote Queensland, Australia, the use of NHF therapy is inconsistent and there are no guidelines on how this therapy should be implemented in practice. Therefore, three remote hospitals within the Torres Strait and Cape York commenced a project to improve consistent and equitable access to NHF therapy...

It is known that environmental heat is associated with increased morbidity manifesting as increasing demand on acute care health services including pre-hospital transport and emergency departments. These services play a vital role in emergency care, and in rural and remote locations, where resource capacity is limited, aeromedical and other retrieval services are a vital part of healthcare delivery. There is no research examining how heat impacts remote retrieval service delivery. The Northern Territory (NT) of Australia is characterised by very remote communities with limited acute healthcare capacities and is a region subject to regular extreme tropical heat...

INTRODUCTION: Migraine is a common condition that can carry considerable risk to aeromedical duties. Because randomized controlled trials are not an appropriate method to evaluate flight safety risk for medical conditions that may cause subtle or sudden incapacitation, the determination of fitness-to-fly must be based on risk assessments informed by extrapolated evidence. Therefore, we conducted a review of current literature to provide background information to inform the aeromedical risk assessment of migraine using a risk matrix approach...

BACKGROUND: The frequency and type of prehospital blood product delivery across Australia and Aotearoa-New Zealand is unknown. This study aims to describe transfusion practice across different services in the two nations, as well as identifying potential barriers to the carriage of blood products. METHODOLOGY: Prehospital and retrieval medicine services operating teams of doctors, specialist paramedics, and/or flight nurses out of specialty bases across Australia and Aotearoa-New Zealand were sent a standardized questionnaire regarding their base characteristics and their current blood transfusion practice...

INTRODUCTION: Management of aeromedical risk is essential for flight safety. Given the many operator stressors for pilots, militaries maintain a vested interest in selecting aircrew applicants who meet rigorous initial medical standards. Very little published literature exists regarding the extent of medical disqualifications or precluding conditions for initial candidates. METHODS: For the British Army, pilot selection is a phased, multistep process that includes Phase I medical screening followed by a comprehensive Phase II medical exam...