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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
Nicole Powell-Dunford, Alaistair Bushby, Richard A Leland
BACKGROUND: This study is intended to identify efficacy, evolving applications, best practices, and challenges of spatial disorientation (SD) training in flight simulators for rotor wing pilots. METHODS: Queries of a UK Ministry of Defense research database and Pub Med were undertaken using the search terms 'spatial disorientation,' 'rotor wing,' and 'flight simulator.' Efficacy, evolving applications, best practices, and challenges of SD simulation for rotor wing pilots were also ascertained through discussion with subject matter experts and industrial partners...
2016: Aerospace Medicine and Human Performance
F Weber
This paper reviews aeromedical decision-making in psychiatry. It explains the "one-percent rule", the general medical criteria for fitness for flying and how they are applied to psychiatric disorders.
September 2016: Fortschritte der Neurologie-Psychiatrie
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
Heidi H Hon, Thomas R Wojda, Noran Barry, Ulunna MacBean, John P Anagnostakos, David C Evans, Peter G Thomas, Stanislaw P Stawicki
BACKGROUND: Aeromedical transport (AMT) is a reliable and well-established life-saving option for rapid patient transfers to health care delivery hubs. However, owing to the very nature of AMT, fatal and nonfatal events may occur. This study reviews aeromedical incidents reported since the publication of the last definitive review in 2003, aiming to provide additional insight into a wide range of factors potentially associated with fatal and nonfatal AMT incidents (AMTIs). We hypothesized that weather and/or visual conditions, postcrash fire, aircraft make and/or type, and time of day all correlate with the risk of AMTI with injury or fatality...
August 2016: Journal of Surgical Research
Ries Simons
Since the tragic accident of Germanwings flight 4U9525, there has been discussion about methods to identify and prevent suicidality in pilots. Neurogenetic scientists claim that biomarker tests for suicidality as part of healthcare assessments may lead to early identification of suicidal behavior. In this commentary the value of these gene expression biomarkers for aeromedical purposes is evaluated based on relevant literature. It is concluded that the currently identified biomarkers for suicidality need thorough validation before they can be used...
July 2016: Aerospace Medicine and Human Performance
Eduard M Ricaurte, William D Mills, Charles A DeJohn, Maria C Laverde-Lopez, Daniel F Porras-Sanchez
BACKGROUND: Since 2004, in the United States, light sport aircraft (LSA) and some aircraft with standard airworthiness certificates can be operated for recreational purposes with a valid state driver's license rather than a Federal Aviation Administration (FAA)-issued aeromedical certificate. There have been recent efforts to allow operation of much larger, heavier, faster, and more complex aircraft without requiring a medical certificate. The primary objective of this research was to compare hazards to flight safety identified in fatally injured pilots required to possess a valid FAA third-class medical certificate to hazards in fatally injured pilots who were not required to possess a valid medical certificate...
July 2016: Aerospace Medicine and Human Performance
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
Andrew R Coggins, Erin N Cummins, Brian Burns
BACKGROUND: Non-invasive ventilation (NIV) therapy is widely used for the management of acute respiratory failure. The objective of this study was to investigate the current use of NIV during interhospital retrievals in an Australian physician-led aeromedical service. METHODS: We reviewed patients receiving NIV during interhospital retrieval at the Greater Sydney Area Helicopter Medical Services (GSA-HEMS) over a 14-month period. The main objectives were to describe the number of retrievals using NIV, the need for intubation in NIV patients and the effect of the therapy on mission duration...
July 1, 2016: Emergency Medicine Journal: EMJ
Marcus D Hayward, Luke Regan, John Glasheen, Brian Burns
OBJECTIVE: There is little current evidence regarding which therapeutic agents are actually used within existing aeromedical services. The Greater Sydney Area Helicopter Emergency Medical Service operates a large, physician-staffed, multimodal, prehospital and interhospital retrieval service. The aim of the present study was to identify the range and frequency of drug, fluid and blood product use within our service. METHODS: This was a retrospective cross-sectional study...
June 2016: Emergency Medicine Australasia: EMA
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
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 Alec 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 i) no vibration (n=7-8), ii) whole body vibration at frequencies and amplitudes simulating helicopter transport (n=8), or iii) whole body vibration simulating ground transportation in an MRAP ambulance (n=7)...
May 23, 2016: Journal of Neurotrauma
Gordon G Cable
BACKGROUND: The occurrence of any intracranial bleeding is highly significant from an aeromedical risk perspective and potentially career-ending for a military aviator. Where it arises from head trauma, there is always concern regarding ongoing risk of post-traumatic epilepsy. CASE REPORT: A 26-yr-old male military aviator with persistent headache was found to have small right frontal and parietal subacute subdural hematomas, most likely precipitated by minor head trauma and possibly exacerbated by other concurrent physiological stressors...
June 2016: Aerospace Medicine and Human Performance
(no author information available yet)
In September 2012, the Aerospace Medical Association published and distributed recommendations from its Pilot Mental Health Working Group to improve awareness and identification of pilot mental health issues during the aeromedical assessment of pilots. Following the crash of Germanwings Flight 9525 in March 2015 with pilot suicide as the probable cause, the Pilot Mental Health Working Group reconvened to review their recommendations. As a result, the working group revised the recommendations which are provided here and which were distributed worldwide...
May 2016: Aerospace Medicine and Human Performance
Christopher Kenedi, Susan Hatters Friedman, Dougal Watson, Claude Preitner
BACKGROUND: This is a systematic review of suicide and homicide-suicide events involving aircraft. In aeromedical literature and in the media, these very different events are both described as pilot suicide, but in psychiatry they are considered separate events with distinct risk factors. METHODS: Medical databases, internet search engines, and aviation safety databases were searched in a systematic way to obtain relevant cases. Relevant articles were searched for additional references...
April 2016: Aerospace Medicine and Human Performance
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
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
Julia A Myers, David M C Powell, Alex Psirides, Karyn Hathaway, Sarah Aldington, Michael F Haney
BACKGROUND: In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Dagmar Muhlbauer, Raveen Naidoo, Timothy C Hardcastle
BACKGROUND: A helicopter emergency medical service (HEMS) is a specialist flying emergency service where on-board medical personnel have both the knowledge and equipment to perform complicated medical procedures. The paucity of literature describing the types of patients flown by HEMS in South Africa (SA) and their clinical outcome poses a challenge for current aeromedical services, as there is no baseline information on which to base flight criteria, staffing and policy documents. This has the potential to hamper the advancement of HEMS in SA...
February 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
J P Gibbons, O Breathnach, J F Quinlan
AIM: This is a retrospective analysis of all consecutive patients requiring emergency aeromedical services (EAS) to a level II trauma centre. This analysis was performed to evaluate the new service to Tallaght Hospital in terms of: the criteria used for dispatch, an estimate of baseline efficiency of time critical management of patients, the cross-catchment transfer of patients. METHODS: Data were provided by the EAS with respect to the patients brought to Tallaght Hospital not including inter-facility transfers for the calendar year 2013...
January 27, 2016: Irish Journal of Medical Science
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