Air medical transport curriculum provides education for medical students.

INTRODUCTION: Increased regionalization of healthcare will most likely result in greater utilization of air medical transport (AMT). Education of providers regarding the utilization and capabilities of AMT will be important. This study was undertaken to determine whether our curriculum in AMT provided a useful and satisfying educational experience for medical students METHODS: The curriculum included three 6-hour fly-along sessions, 2 hours of lectures, 2 hours of case review, an 80-page syllabus listing articles and position papers, and a 3-page writing assignment. The study was a review of the participants' (1st- and 2nd-year medical students) test scores and postelective evaluation for 1 year. The setting was a two-helicopter AMT program based at an urban, university-affiliated level 1 trauma center. Twelve students (1/month) participated in the month-long elective. The students took a 20-item test before and after the elective and a 15-item postelective evaluation (5-point scale: very dissatisfied, dissatisfied, neutral, satisfied, very satisfied). A paired t-test was used to compare the mean pre-test and mean post-test scores. The evaluation data were analyzed descriptively. RESULTS: The mean number of correct responses on the post-test (M = 18.67, SD = 1.61) was significantly higher than the mean number of correct responses on the pretest (M = 13.83, SD = 2.17), P < .001. All students were either satisfied (56%) or very satisfied (44%) with the lectures and case review. Eleven (91%) were very satisfied with interaction with the crew, and nine (75%) were very satisfied overall (25% satisfied). Seven (58%) were very likely to use AMT in their career, two (16.7%) likely, two (16.7%) unsure, and one (8.3%) unlikely. CONCLUSIONS: Our curriculum in AMT provided a useful and satisfying educational opportunity for medical students. Their knowledge of AMT increased, and all were satisfied or very satisfied with the didactics and the crew interaction. Most thought that they would use AMT in their career.

Comparison of nitrile gloves and nitrile over Nomex gloves.

OBJECTIVES: Aeromedical flight crews must perform many tasks in flight requiring manual dexterity and fine precision. A common perception is that safety-enhancing fire-retardant gloves compromise patient care if worn during such tasks by providing added bulk and barrier to the hand. This study is a quantitative and qualitative analysis of this possible compromise to patient care. METHODS: Sixteen practicing flight nurses and respiratory therapists were asked to perform 10 different standard patient care tasks while wearing either nitrile gloves or a nitrile-Nomex glove pair. Tasks were timed, rated as completed successfully or not, and were subsequently judged subjectively by the participants. RESULTS: Whereas the time required to insert an intravenous catheter and to insert a central line while wearing only nitrile gloves was significantly faster than when wearing both gloves, the time to perform all other tasks was not significantly different. In subjective ratings, the nitrile glove alone was scored significantly better than the two-glove combination by the study participants. CONCLUSIONS: Comfort, dexterity, tactile discrimination, and ease of use were all adversely affected by wearing a Nomex glove under a nitrile glove. Although the differences in times for most tasks may not be clinically significant, the difference in the subjective parameters may be great enough to cause helicopter emergency medical services (HEMS) practitioners to not wear Nomex gloves under nitrile gloves while performing procedures.

Presumption of death by air medical transport teams.

BACKGROUND: The purpose of this study was to investigate nationwide trends and factors influencing the determination of death practice by rotor-wing air medical transport programs. METHODS: A survey was mailed to all Association of Air Medical Service members concerning demographics, crew configuration, team leader, patient population, field death determination protocols, and other possible associated factors. All rotor-wing air medical transport programs that carry out scene transports were included. RESULTS: The most common field presumption criteria were no response to advanced cardiac life support (77%), no signs of life on scene (65%), and asystole in 2 EKG monitor leads (61%). The most frequent reasons cited not to presume a patient dead in the field were political issues (71%) and signs of life on scene (56%). Criteria other than medical condition that were considered in the decision to presume death were ground personnel input (55%) and program policy/medical control (39%). The following factors did not significantly affect the presumption rate: crew configuration, team leader, transport time, billing, and type of medical control. CONCLUSION: Medical criteria appear to determine presumption of death in the field. Nonmedical factors, such as billing, response, and transport times, do not affect this process.