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1.
Aerosp Med Hum Perform ; 90(8): 725-729, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31331423

RESUMEN

INTRODUCTION: Aerospace medicine training is often difficult to obtain outside of military education streams. Undergraduate medical trainees and residents may undertake training opportunities, but often have trouble locating programs and/or receiving credit for their experiences and learning. In many countries, no formal aerospace medicine training program or pathway exists and trainees must search out opportunities on their own. Canada is used as an example of a country which, until recently, had no defined civilian aerospace medicine training program or credentialing pathway. Recent development of a Diploma in Aerospace Medicine certified by the Royal College of Physicians and Surgeons now outlines a series of competencies for trainees and medical professionals seeking advancement in aerospace medicine. Growth of the aviation and aerospace fields will require more training opportunities and more aerospace medicine professionals to support the increased number of aviators and the spacefaring population. This will be particularly important as commercial space companies develop the potential for civilian spaceflight. While few opportunities exist for training, we highlight the major aerospace medicine training opportunities that have been recently available to Canadians. It is our hope that highlighting previous and current opportunities may aid in the development of a formal training program leading to certification in aerospace medicine for Canadians and act as an example for other nations.Sirek A, Samoil K, Harrison MF. Space medicine training in Canada. Aerosp Med Hum Perform. 2019; 90(8):725-729.


Asunto(s)
Medicina Aeroespacial/educación , Educación Médica Continua , Vuelo Espacial , Canadá , Certificación , Humanos
2.
Dimens Crit Care Nurs ; 38(2): 83-89, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30702477

RESUMEN

BACKGROUND: The Air Force has unique challenges in ensuring clinical proficiency for en route care clinicians. These challenges pertain to existing care environments, training opportunities, and the spectrum of training needed to care for patients with polytrauma and complicated medical conditions while being transported between medical treatment facilities. OBJECTIVE: The purpose of this study was to identify the clinical education needs of students entering the United States Air Force School of Aerospace Medicine Flight Nurse (FN) or Aeromedical Evacuation Technician (AET) course and Air Force FNs and AETs assigned to active duty aeromedical evacuation units. METHOD: We recruited 198 students enrolled in the FN or AET course and 103 active duty FN and AET aircrew members and conducted a gap analysis to identify the clinical education needs of Air Force FNs and AETs. RESULTS: Training gaps were identified for active duty Air Force, Air Force Reserve, and Air National Guard FNs and AETs. The greatest learning needs included use of the portable therapeutic liquid oxygen unit, manual resuscitators, and negative pressure wound therapy systems, and care of special populations such as patients with a burn injury or mental health disorder. CONCLUSIONS: Results of the gap analysis can be used to select and develop educational and simulation training scenarios designed to foster clinical competence.


Asunto(s)
Medicina Aeroespacial/educación , Ambulancias Aéreas , Competencia Clínica , Personal Militar/educación , Estudios Transversales , Humanos , Estados Unidos
3.
Aerosp Med Hum Perform ; 89(12): 1076-1079, 2018 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-30487028

RESUMEN

INTRODUCTION: In-flight medical emergencies require healthcare providers to operate in confined spaces with limited resources and delayed access to definitive care. These emergencies are common, with an estimated frequency of 1 per 100 to 1000 flights. Despite this, training for medical response in these environments is limited. We hypothesize that integrating such education into a pre-existing medical student elective course would improve knowledge and ability to respond appropriately to in-flight medical emergencies.METHODS: The available literature surrounding in-flight medical emergencies was reviewed. Syncope, respiratory distress, allergic reaction, and cardiac arrest were identified as common and potentially life-threatening complaints. Simulation cases were designed for each of these complaints and a simulation room was modified to mimic an airplane cabin. These simulation cases and accompanying relevant didactic lectures were incorporated into an existing wilderness and extreme environmental medicine course, with multiple-choice tests completed by the students at the beginning and end of the 2-wk course.RESULTS: Participating in this study were 18 students. The pretest average was 76%, which improved to 87% on the posttest. Qualitative feedback regarding this type of training was overwhelmingly positive.DISCUSSION: Simulation-based training for in-flight medical emergencies can significantly improve medical students' knowledge. This training was very well received by the students. Opportunities for training to manage in-flight medical emergencies remain limited; incorporating such training into existing curricula could provide a means by which to improve provider knowledge. Such a curriculum could be adapted for use by flight crews and other populations.Padaki A, Redha W, Clark T, Nichols T, Jacoby L, Slivka R, Ranniger C, Lehnhardt K. Simulation training for in-flight medical emergencies improves provider knowledge and confidence. Aerosp Med Hum Perform. 2018; 89(12):1076-1079.


Asunto(s)
Aeronaves , Competencia Clínica , Enfermedades Profesionales/prevención & control , Adulto , Medicina Aeroespacial/educación , Anciano , Curriculum , Urgencias Médicas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Entrenamiento Simulado , Adulto Joven
5.
Mil Med ; 183(9-10): e383-e391, 2018 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-29547887

RESUMEN

INTRODUCTION: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role. Historically, evaluations of ERC and patient outcomes have been based on retrospective analyses of incomplete data sets that provide limited insight on ERC practices. Little evidence exists to determine if current training is adequate to care for the most common injuries seen in combat trauma patients. MATERIALS AND METHODS: Simulation technology facilitates a standardized patient encounter to enable complete, prospective data collection while studying provider type as the independent variable. Information acquired through skill performance observation can be used to make evidence-based recommendations to improve ERC training. This IRB approved multi-center study funded through a Congressionally Directed Medical Research Program grant from the Combat Casualty Care Intramural Research Joint En Route Care portfolio evaluated Navy ERC providers. The study evaluated 84 SMT, ERC RN, and physician participants in the performance of critical and secondary actions during an immersive, high-fidelity, patient transport simulation scenario focused on the care during an interfacility transfer. Simulation evaluators with military ERC expertise, blinded to participant training and background, graded each participant's performance. Inter-rater reliability was calculated using Cohen's Kappa to evaluate concordance between evaluator assessments. Categorical data were reported as frequencies and percentages. Performance attempt and accuracy rates were compared with likelihood ratio chi-square or Fisher's exact test where appropriate. Tests were two-tailed and we considered results significant, that is, a difference not likely due to chance exists between groups, if p < 0.05. Confidence intervals were used to present overlap in performance between provider types. RESULTS: Critical and secondary actions were assessed. A majority of providers completed at least one of the critical life-saving actions; only one participant completed all critical actions. Evaluation of critical actions demonstrated that a tourniquet was applied by 64% of providers, blood products administered by 46%, needle decompression performed by 51%, and a complete handoff report performed by 48%. Assessment of secondary actions demonstrated analgesic was accurately administered by 24% of all providers, and 44% reinforced the "hemorrhaging amputation site dressing." CONCLUSION: Over 98% of participants failed to properly perform all critical actions during the interfacility transfer scenario, which in a real-life combat casualty transport scenario could result in a preventable death. Study results demonstrate serious skill deficits among all types of Navy ERC providers. These data can be used to improve the training of Navy ERC providers, ultimately improving care to injured soldiers, sailors, airmen, and marines.


Asunto(s)
Medicina Aeroespacial/educación , Transferencia de Pacientes/métodos , Entrenamiento Simulado/normas , Medicina Aeroespacial/normas , Distribución de Chi-Cuadrado , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Evaluación Educacional/métodos , Servicios Médicos de Urgencia/métodos , Servicios Médicos de Urgencia/normas , Humanos , Personal Militar/estadística & datos numéricos , Simulación de Paciente , Transferencia de Pacientes/normas , Evaluación de Programas y Proyectos de Salud/métodos , Estudios Prospectivos , Entrenamiento Simulado/métodos , Entrenamiento Simulado/estadística & datos numéricos
6.
Disaster Med Public Health Prep ; 12(6): 675-679, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-29352835

RESUMEN

OBJECTIVE: Despite lessons learned from the recent Ebola epidemic, attempts to survey and determine non-health care worker, industry-specific needs to address highly infectious diseases have been minimal. The aircraft rescue and fire fighting (ARFF) industry is often overlooked in highly infectious disease training and education, even though it is critical to their field due to elevated occupational exposure risk during their operations. METHODS: A 44-question gap analysis survey was distributed to the ARFF Working Group to determine where highly infectious education and training can be improved. In total, N=245 responses were initiated and collected. Descriptive statistics were generated utilizing Qualtrics Software Version 2016.17©. RESULTS: Supervisors perceived Frontline respondents to be more willing and comfortable to encounter potential highly infectious disease scenarios than the Frontline indicated. More than one-third of respondents incorrectly marked transmission routes of viral hemorrhagic fevers. There were discrepancies in self-reports on the existence of highly infectious disease orientation and skills demonstration, employee resources, and personal protective equipment policies, with a range of 7.5%-24.0% more Supervisors than Frontline respondents marking activities as conducted. CONCLUSIONS: There are deficits in highly infectious disease knowledge, skills, and abilities among ARFF members that must be addressed to enhance member safety, health, and well-being. (Disaster Med Public Health Preparedness. 2018;12:675-679).


Asunto(s)
Medicina Aeroespacial/métodos , Bomberos/educación , Evaluación de Necesidades/tendencias , Trabajo de Rescate/métodos , Enseñanza/normas , Medicina Aeroespacial/educación , Aeronaves , Bomberos/estadística & datos numéricos , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/transmisión , Humanos , Trabajo de Rescate/tendencias , Encuestas y Cuestionarios , Enseñanza/tendencias
7.
J Nutr Health Aging ; 21(9): 1024-1030, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29083444

RESUMEN

An open discussion between experts from life sciences and aeronautics has been held in order to investigate how both area of research overlap and could be relevant to each other, precisely on the topic of aging. Similarities in aging processes and prediction methodologies have been identified between human aging and aircraft aging. Two axis of collaboration have been raised: 1) The identification of the determinants in Aircraft aging (structural aging). 2) The development of P4 Systems medicine inspired new methodologies in the predictive maintenance.


Asunto(s)
Medicina Aeroespacial/educación , Disciplinas de las Ciencias Biológicas/educación , Envejecimiento , Estudios de Seguimiento , Humanos , Estudios Prospectivos
8.
Mil Med ; 182(7): e1718-e1721, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28810963

RESUMEN

BACKGROUND: High-altitude flight simulation familiarizes military trainees with the symptoms of hypoxia to prepare them for emergency situations. Decompression sickness (DCS) can occur as a result of these simulations. In cases when ground-level supplemental oxygen does not resolve symptoms, hyperbaric oxygen (HBO) therapy is indicated. Many military hyperbaric chambers have been closed because of cost reductions, necessitating partnerships with community hospitals to ensure access to treatment. MATERIALS AND METHODS: This article describes the unique arrangement between a community hospital in Colorado and a military training site to treat DCS cases emergently. We gathered cost data from the community hospital to estimate and compare the cost of providing HBO therapy in the hospital versus a standalone chamber similar to the former military hyperbaric chamber. RESULTS: Since the closure of the military hyperbaric chamber, the community hospital treated an estimated 50 patients with DCS requiring HBO therapy attributed to high-altitude flight simulation between October 2003 and April 2015. Cost to the institution providing HBO treatment varies widely on the basis of patient volume. Assuming a volume of five treatments, per-treatment cost at a standalone center is $95,380. In contrast, per-treatment cost at the hospital assuming a volume of 1,000 treatments commensurate with the hospital's ability to bill for other services is $698 per treatment. CONCLUSION: The cost analysis demonstrates that the per-treatment cost of operating a standalone HBO therapy center may be greater than 100 times that of operating a center at a community hospital, suggesting the arrangement is beneficial to the military.


Asunto(s)
Medicina Aeroespacial/educación , Enfermedad de Descompresión/terapia , Oxigenación Hiperbárica/tendencias , Asociación entre el Sector Público-Privado/tendencias , Enseñanza/organización & administración , Adolescente , Adulto , Colorado , Femenino , Hospitales Comunitarios/organización & administración , Humanos , Oxigenación Hiperbárica/métodos , Masculino
10.
J Surg Res ; 215: 67-73, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28688664

RESUMEN

BACKGROUND: Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. METHODS: From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health. During the 2016 iteration attended by 10 interns, pre- and post-participation 10-item Likert scale surveys were administered. Questions focused on perceived preparedness for primary care role and overall enthusiasm for flight medicine. Open-ended surveys from 2013 to 2016 were also used to gauge the effect of the curriculum. RESULTS: The composite number of agreement responses (indicating increased comfort with presented material) increased 63% after course completion. Disagreement responses and neutral responses decreased 78% and 30%, respectively. Open-ended surveys from 14 participants showed an overall positive impression of the curriculum with all indicating it aided their transition to flight medicine. CONCLUSIONS: Survey responses indicate an overall perceived benefit from participation in the curriculum with more confidence in primary care topics and improved transition to a flight medicine tour. This model for supplemental aerospace medicine and primary care didactics should be integrated into any residency program responsible for training military preliminary interns who may serve as flight surgeons.


Asunto(s)
Medicina Aeroespacial/educación , Cirugía General/educación , Internado y Residencia/métodos , Personal Militar/educación , Modelos Educacionales , Competencia Clínica , Curriculum , Femenino , Humanos , Masculino , Atención Primaria de Salud , Estados Unidos
13.
Voen Med Zh ; 336(4): 81-3, 2015 Apr.
Artículo en Ruso | MEDLINE | ID: mdl-26454942

RESUMEN

In the current paper authors discuss problems of marine and aerospace medicine and psychophysiology, which Georgii Zarakovskii (1925-2014), a prominent domestic experts in the field of military medicine, psychology and ergonomics, solved. Authors focused on methodological approaches and results of the study of psychophysiological characteristics and human capabilities took into account for design of tools and organization of flight crews, astronauts and military experts. Authors marked the contribution to the creation of a system integrating psychophysiological features and characteristics of the person neccessary for development, testing and maintenance of aerospace engineering and organization of its professional activities. The possibilities of using the methodology of psychophysiological activity analysis in order to improve the reliability of psychophysiological military specialists, are shown.


Asunto(s)
Medicina Aeroespacial/historia , Medicina Naval/historia , Fisiología/historia , Psicología/historia , Academias e Institutos/historia , Medicina Aeroespacial/educación , Medicina Aeroespacial/organización & administración , Historia del Siglo XX , Historia del Siglo XXI , Medicina Naval/educación , Medicina Naval/organización & administración , Fisiología/educación , Fisiología/organización & administración , Psicología/educación , Psicología/organización & administración , Federación de Rusia
16.
Voen Med Zh ; 336(1): 61-6, 2015 Jan.
Artículo en Ruso | MEDLINE | ID: mdl-25916039

RESUMEN

Thee article is a brief description of the current state of the Finnish Defence Forces medical service and is based on the study of the open access foreign sources. At the beginning, the general information about Finland, the Finnish Defence Forces, and their medical service is presented. Then some particular features are described with more detail, namely, the organization of the inpatient and outpatient treatment, medical supply, scientific research, combat medicine, medical staff education and training, medical , service personnel income.


Asunto(s)
Medicina Aeroespacial/organización & administración , Medicina Militar/organización & administración , Medicina Naval/organización & administración , Medicina Aeroespacial/educación , Medicina Aeroespacial/métodos , Educación Médica/organización & administración , Finlandia , Humanos , Medicina Militar/educación , Medicina Militar/métodos , Personal Militar , Medicina Naval/educación , Medicina Naval/métodos
17.
J R Nav Med Serv ; 101(2): 186-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26867422

RESUMEN

Hypoxia training at the Royal Air Force Centre of Aviation Medicine (RAF CAM) has traditionally involved the use of a hypobaric chamber to induce hypoxia. While giving the student experience of both hypoxia and decompression, hypobaric chamber training is not without risks such as decompression sickness and barotrauma. This article describes the new system for hypoxia training known as Scenario-Based Hypoxia Training (SBHT), which involves the subject sitting in an aircraft simulator and wearing a mask linked by hose to a Reduced Oxygen Breathing Device (ROBD). The occupational requirements to be declared fit for this new training method are also discussed.


Asunto(s)
Medicina Aeroespacial/educación , Hipoxia , Humanos , Reino Unido
18.
West J Emerg Med ; 15(7): 925-9, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25493155

RESUMEN

INTRODUCTION: In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies. METHODS: A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. RESULTS: 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. CONCLUSION: This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flight medical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medical education.


Asunto(s)
Medicina Aeroespacial/educación , Competencia Clínica/estadística & datos numéricos , Educación de Pregrado en Medicina , Medicina de Emergencia/educación , Viaje , Adulto , Estudios Transversales , Urgencias Médicas , Femenino , Humanos , Masculino , Evaluación de Necesidades , Autoevaluación , Encuestas y Cuestionarios , Estados Unidos
19.
J Health Organ Manag ; 28(6): 731-53, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25420354

RESUMEN

PURPOSE: The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. DESIGN/METHODOLOGY/APPROACH: Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. FINDINGS: The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. RESEARCH LIMITATIONS/IMPLICATIONS: The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. ORIGINALITY/VALUE: Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.


Asunto(s)
Medicina Aeroespacial/educación , Capacitación en Servicio , Grupo de Atención al Paciente , Seguridad del Paciente , Transferencia de Tecnología , Humanos , Cuerpo Médico de Hospitales , Países Bajos , Cultura Organizacional , Investigación Cualitativa
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