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Flight critical care nurse

David Hersey, Tobias Witter, George Kovacs
We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe acute respiratory distress patient prior to transport to an extracorporeal membrane oxygenation capable teaching hospital. With the increasing use of advanced treatments such as extracorporeal membrane oxygenation, prone positioning, and continuous renal replacement therapy for severe acute respiratory distress syndrome (ARDS), the necessity to transport these patients to specialized hospitals will correspondingly increase...
May 2018: Air Medical Journal
Margaret M McNeill
BACKGROUND: Critical Care Air Transport Teams care for 5% to 10% of injured patients who are transported on military aircraft to definitive treatment facilities. Little is known about how the aeromedical evacuation environment affects care. OBJECTIVES: To determine the effects of 2 stressors of flight, altitude-induced hypoxia and aircraft noise, and to examine the contributions of fatigue and clinical experience on cognitive and physiological performance of the Critical Care Air Transport Team...
April 2018: Critical Care Nurse
David M Kaniecki, Ronald L Hickman, Celeste M Alfes, Andrew P Reimer
OBJECTIVE: The purpose of this study was to determine if a helicopter flight simulator could provide a useful educational platform by creating experiences similar to those encountered by actual flight nurses. METHODS: Flight nurse (FN) and non-FN participants completed a simulated emergency scenario in a flight simulator. Physiologic and psychological stress during the simulation was measured using heart rate and perceived stress scores. A questionnaire was then administered to assess the realism of the flight simulator...
May 2017: Air Medical Journal
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
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
Eric M Campion, Catherine Juillard, M Margaret Knudson, Rochelle Dicker, Mitchell J Cohen, Robert Mackersie, Andre R Campbell, Rachael A Callcut
IMPORTANCE: To date, a substantial portion of multiple casualty incident literature has focused exclusively on prehospital and emergency department resources needed for optimal disaster response. Thus, inpatient resources required to care for individuals injured in multiple casualty events are not well described. OBJECTIVE: To highlight the resources beyond initial emergency department triage needed for multiple casualty events, using one of the largest commercial aviation disasters in modern US history as a case study...
June 1, 2016: JAMA Surgery
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
Bradley Boehringer, Michael Choate, Shelley Hurwitz, Peter V R Tilney, Thomas Judge
Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway. Over a nine-year period a helicopter emergency medical services team, comprised of a flight paramedic and flight nurse, intended to intubate 790 patients...
2015: BioMed Research International
Claire L Barker, Mark Ross
OBJECTIVE: The primary objective of this study was to describe the remote paediatric aeromedical population of the 'Top End' of the Northern Territory. The secondary objective was to identify children requiring high-dependency care by the transport team. DESIGN: Retrospective case review. SETTING: Aeromedical service in the remote Northern Territory. PARTICIPANTS: All patients under the age of 16 years transported over a one-year period between February 2012 and February 2013...
February 2014: Australian Journal of Rural Health
Torben Wisborg, Bjørn Bjerkan
OBJECTIVE: Flight nurses in the Norwegian National Air Ambulance Service are specialist nurse anesthetists or intensive care nursing specialists. For air ambulance bases far from hospitals, these nurses present otherwise unavailable competencies. This study reports a 6-year experience with flight nurse participation in local emergencies beyond the transportation phase. METHODS: The fixed-wing air ambulance base in Alta, Northern Norway (20,000 inhabitants), with 2 aircraft and 2 on-call teams is 150 km by road from the nearest hospital...
January 2014: Air Medical Journal
P Daniel Patterson, Judith R Lave, Christian Martin-Gill, Matthew D Weaver, Richard J Wadas, Robert M Arnold, Ronald N Roth, Vincent N Mosesso, Francis X Guyette, Jon C Rittenberger, Donald M Yealy
INTRODUCTION: We sought to create a valid framework for detecting adverse events (AEs) in the high-risk setting of helicopter emergency medical services (HEMS). METHODS: We assembled a panel of 10 expert clinicians (n = 6 emergency medicine physicians and n = 4 prehospital nurses and flight paramedics) affiliated with a large multistate HEMS organization in the Northeast US. We used a modified Delphi technique to develop a framework for detecting AEs associated with the treatment of critically ill or injured patients...
January 2014: Prehospital Emergency Care
Joanne M Minnick, Vikhyat S Bebarta, Marietta Stanton, Julio R Lairet, James King, Pedro Torres, James Aden, Rosemarie Ramirez
INTRODUCTION: Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. METHODS: We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia...
November 2013: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
H Trimmel, R Fitzka, J Kreutziger, A von Goedecke
Adverse events are not unusual in a more and more complex anesthesiological environment. The main reasons for this are an increasing workload, economic pressure, growing expectations of patients and deficits in planning and communication. However, these incidents mostly do not refer to medical deficits but to flaws in non-technical skills (team organisation, task orientation, decision making and communication). The introduction of the WHO Safe Surgery Checklist depicted that a structural approach can improve the situation...
January 2013: Der Anaesthesist
Robert L Mabry, Amy Apodaca, Jason Penrod, Jean A Orman, Robert T Gerhardt, Warren C Dorlac
BACKGROUND: The US Army pioneered medical evacuation (MEDEVAC) by helicopter, yet its system remains essentially unchanged since the Vietnam era. Care is provided by a single combat medic credentialed at the Emergency Medical Technician - Basic level. Treatment protocols, documentation, medical direction, and quality improvement processes are not standardized and vary significantly across US Army helicopter evacuation units. This is in contrast to helicopter emergency medical services that operate within the United States...
August 2012: Journal of Trauma and Acute Care Surgery
Yvonne E Franco, Robert A De Lorenzo, Steven W Salyer
During the Second Iraq War (Operation Iraqi Freedom), high-intensity, low-utilization medical and surgical services, such as neurosurgical care, were consolidated into a centralized location within the combat zone. This arrangement necessitated intra-theater air medical evacuation of critically ill or injured patients from outlying combat support hospitals (CSH) to another combat zone facility having the needed services. A case series is presented of intratheater transfer of neurosurgical patients in Iraq during 2005-06...
July 2012: Air Medical Journal
Kris Bauer
Trauma is the leading cause of death in the United States for those younger than 35 years and injuries sustained from trauma are a significant source of moderate to severe disability. The inability to establish, secure, or maintain a definitive airway is a major cause of preventable death and secondary injury due to inadequate oxygenation and ventilation. Prehospital airway management is an essential skill of any prehospital care provider. A critical component to providing excellent airway management is the ability of the provider to quickly establish endotracheal intubation without complications such as hypoxia, hyper/hypocapnea, or hypotension...
July 2012: Critical Care Nursing Quarterly
Chun-Lan Lee, Yun-Chien Hsiao, Chao-Yen Chen
Evacuating the injured is an important part of disaster medicine. Aircraft provide timely access to distant and remote areas and, in an emergency, can evacuate sick or injured individuals in such areas quickly and safely for critical treatment elsewhere. Aeromedical evacuation (AE) comprises the two categories of fixed-wing ambulance service and helicopter emergency medical service (HEMS). Each aims to accomplish unique objectives. In Taiwan, the Second Taiwan Strait Crisis in 1958 established the unique role and functions of medical flight nursing...
June 2012: Hu Li za Zhi the Journal of Nursing
Hsin-Mao Shen, Shu-Yuan Chao
Nurses play a critical role in Taiwan's helicopter emergency medical service, an essential healthcare response service for residents of outlying islands. The care skillsets required of nurses in special care and urgent care environments are significantly more specialized than those in other professional care environments. This article discusses the development of the civil helicopter emergency medical service (HEMS) and elements essential to HEMS nursing care efficacy. These elements can be grouped under the categories of pre-flight preparation, assessment for flight-readiness and in-flight care, decision-making abilities, personal physical characteristics, training and experience...
June 2012: Hu Li za Zhi the Journal of Nursing
Julia A Myers, Alex Psirides, Karyn Hathaway, Peter D Larsen
AIM: To describe and characterise the interhospital transport workload of a New Zealand based flight service over a 5-year period. METHOD: Wellington Flight Service database records from 1 November 2005 to 31 October 2010 were reviewed. Details of mission purpose, timings, transport type, severity of illness, clinical service requesting the transfer, and medical crew in attendance, were examined. RESULTS: The Flight Service completed 4046 transport missions over 5 years...
March 9, 2012: New Zealand Medical Journal
Susan J Black, Elizabeth M Carson, Andrea Doughty
INTRODUCTION: Application of cricoid pressure is a frequently used technique in both rapid sequence intubation in multiple settings and in a more controlled setting in the operating room. In a survey of emergency department personnel performed at the University of Michigan, it was found that there is a knowledge deficit in the recommended force and the anatomic localization of cricoid pressure. Participants in the original study, which included emergency nurses, medical residents, and attending physicians, rated their training in cricoid pressure as poor or nonexistent...
July 2012: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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