RESUMO
This article focuses on the clinical and administrative decision-making processes involved in medevacing psychiatric patients from Kandahar Airfield, Afghanistan, during major surge operations. This article highlights organizational realities pertaining to the medevac process and offers recommendations for incoming providers to optimize their effectiveness in managing at-risk patients in a combat zone.
Assuntos
Campanha Afegã de 2001- , Resgate Aéreo/estatística & dados numéricos , Tomada de Decisões , Resgate Aéreo/classificação , Distúrbios de Guerra/psicologia , Humanos , Medicina MilitarRESUMO
INTRODUCTION: Previous studies within the aeromedical literature have looked at factors associated with fatal outcomes in helicopter medical transport, but no analysis has been conducted on fixed-wing aeromedical flights. The purpose of this study was to look at fatality rates in fixed-wing aeromedical transport and compare them with general aviation and helicopter aeromedical flights. METHODS: This study looked at factors associated with fatal outcomes in fixed-wing aeromedical flights, using the National Transportation Safety Board Aviation Accident Incident Database from 1984 to 2009. RESULTS: Fatal outcomes were significantly higher in medical flights (35.6 vs. 19.7%), with more aircraft fires (20.3 vs. 10.5%) and on-ground collisions (5.1 vs. 2.0%) compared with commercial flights. Aircraft fires occurred in 12 of the 21 fatal crashes (57.1%), compared with only 2 of the 38 nonfatal crashes (5.3%) (P < .001). In the multiple logistic regression model, the only factor with increased odds of a fatal outcome was the presence of a fire (56.89; 95% CI, 4.28-808.23). CONCLUSIONS: Similar to published studies in helicopter medical transport, postcrash fires are the primary factor associated with fatal outcomes in fixed-wing aeromedical flights.
Assuntos
Acidentes Aeronáuticos/mortalidade , Resgate Aéreo/classificação , Acidentes Aeronáuticos/classificação , Bases de Dados como Assunto , Incêndios , Humanos , Estudos RetrospectivosRESUMO
In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.
Assuntos
Resgate Aéreo/organização & administração , Serviços Médicos de Emergência/organização & administração , Transporte de Pacientes/organização & administração , Resgate Aéreo/classificação , PolôniaAssuntos
Resgate Aéreo/organização & administração , Administração de Caso/organização & administração , Transporte de Pacientes/organização & administração , Resgate Aéreo/classificação , Comportamento de Escolha , Custos de Cuidados de Saúde , Humanos , Avaliação das Necessidades/organização & administração , Papel do Profissional de Enfermagem , Seleção de Pacientes , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Transporte de Pacientes/classificaçãoRESUMO
The Air Transport Minimum Data Set (ATMDS) was developed to address data needs for rotor wing transport of critically ill or injured patients. Using a focus group methodology, nurses, paramedics, pilots, and communications specialists identified additional concepts such as time arrived at airport via ground transportation to represent the complexity present in fixed wing transport. Specific concepts, selected terms for the concepts and definitions will be discussed.
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Resgate Aéreo/classificação , Terminologia como Assunto , Grupos Focais , HumanosRESUMO
The 1994 Avionics and Airframe Survey was sent to 178 chief or lead pilots of helicopter emergency medical services (HEMS) programs in October 1993, and 100 (56%) were returned. Sixty-four programs (64%) reported that they operate one helicopter exclusively for EMS, 24 (24%) operate two, and 12 (12%) reported using three or more aircraft. Interestingly, the reported percentage of programs with two or more exclusive helicopters continues to rise, increasing by 5.6% to 36%.