Humanitarian Aeromedical Retrieval using a Long-Range Commercial Aircraft: A Field Report.

This field report presents the planning and execution of a large-scale aeromedical refugee retrieval operation amid the on-going Russia-Ukraine crisis. The retrieval was coordinated by the Italian Department of Civil Protection and led by the Centrale Remota Operazioni Soccorso Sanitario (CROSS), a governmental facility overseeing medical assistance. An Airbus A320 was chosen for its capacity of 165 passengers, with one emergency stretcher maintaining maximum seating. The aircraft was equipped with an Advanced Life Support kit, and specific considerations for medical equipment compliance were made. Special cases, including patients with on-going chemotherapy and end-stage kidney disease, underwent fit-to-fly screening. The boarding process in Lublin, Poland involved triage and arrangements for passengers with gastroenteric symptoms. Notably, 22 passengers with recent episodes of illness were isolated. The successful operation, demonstrating the viability of evacuating vulnerable individuals via commercial airlines, underscores the importance of precise planning and coordination in crisis situations.

An unusual case of marathon-related exercise associated collapse: Case report and some considerations for medical care at endurance mass participation events.

This article presents a unique exercise-associated collapse case during a marathon, highlighting the significance of evidence-based management for athletes on field. The patient, a 61-year-old experienced runner, collapsed near the finish line of the Milano City Marathon. He was aided immediately with CPR and AED. After excluding, through validated algorithms, common and life-threatening causes of collapse, the patient was transferred to hospital. The patient underwent diagnostic procedures, including CT and MRI scans, and hormonal tests that revealed pituitary hemorrhage and underlying coronary artery disease. Follow-up assessments and personalized care were instrumental in the patient's successful recovery and safe return to exercise.

Role of emergency teleradiology in a mass motorcycle event: the experience of the 2021 International Six Days of Enduro (ISDE).

PURPOSE: Provision of healthcare support at mass gathering sporting events is of paramount importance for the success of the event. Many of such events, like motorsports, have been increasingly taking place in remote and austere environments. In these settings, the use of first-line diagnostic tools, such as point of care ultrasound and portable X-ray, could aid in definitive care on the field for patients with minor trauma while also ensuring fast access to the appropriate level of care for patients requiring hospitalization. METHODS: As part of the ISDE 2021 medical response plan, a field hospital equipped with portable digital X-ray and telemedicine was established. Data on patient admission, triage, treatments, diagnostics, and outcomes were collected for analysis. RESULTS: During the 6-day competition, 79 patients sought medical care at the field hospital, with traumatic injuries accounting for 77% of cases. Of these, 47 were athletes and 32 were non-athletes. The majority (91%) arrived spontaneously, while 9% were transported directly. Upon admission, 68 patients were triaged as non-urgent (code 3) and 11 as urgent (code 2). Of those admitted, 69 received treatment and were discharged at the field hospital, while 10 were transferred elsewhere. Notably, four patients had major trauma, two had isolated fractures, and one needed a CT scan after losing consciousness. Overall, 29 missions were conducted on the race field, including 13 primary transports to local hospitals and 6 to the field hospital. Primary transport was primarily due to major trauma. Among 31 patients who had radiological exams, 11 (35.5%) had traumatic injuries. Of these, 5 were treated with braces and casts and discharged without hospitalization, 3 were advised for post-event care, and 3 were hospitalized. In contrast, patients with negative X-rays received on-site treatment, with 7 able to continue competing. CONCLUSIONS: In summary, the successful implementation of portable X-ray machines and teleradiology at remote and austere high-risk sporting events holds great promise for enhancing on-site medical capabilities, allowing clinicians informed decisions, avoiding unnecessary hospitalization, and allowing athletes to continue with their competition. Provided that challenges related to cost, safety, connectivity, and power supply are effectively addressed.