Competencies for aeromedical evacuation practices in emergencies and disasters: a scoping review / Competencias para prácticas de evacuación aeromédica en emergencias y desastres: revisión del alcance / Competências para práticas de evacuações aeromédicas em emergências e desastres: revisão de escopo

ABSTRACT Objective: to map the competencies developed in training strategies for air transport practices for patients, in the face of emergency situations and disasters involving chemical, biological, radiological and nuclear (CBRN) agents. Method: this is a scoping review structured in accordance with the JBI and Preferred Reporting Items for Systematic reviews and Metanalyses extension for Scoping Reviews recommendations. The study was carried out in five stages: search for sources in 17 databases, an information portal and two repositories of gray literature, using 125 DeCS, MeSH and Emtree descriptors, without temporal and idiomatic clipping; selection; critical reading of the texts selected by two double-blind reviewers; summary of results and presentation of mapped competencies. Results: a total of 878 studies were analyzed, of which 18 composed the sample. In all, 11 competencies were mapped, with emphasis on the technical training domain. Competencies refer especially to technical-scientific knowledge in disaster situations involving CBRN agents and the safety of patients and professionals involved. Conclusion: the operationalization of artifices to improve qualification processes based on competencies proved to be strategic to increase the quality and safety of patient air transport practices. The approach of the sources on specific aspects of the particularities of practices related to emergencies and disasters involving CBRN agents in training/training processes demonstrates the academic effort to promote the reduction of the risk of these events when, in due course, civil and military institutions and their health operators are activated.

RESUMEN Objetivo: mapear las competencias desarrolladas en estrategias de formación en prácticas de transporte aéreo de pacientes, ante situaciones de emergencia y desastres con agentes químicos, biológicos, radiológicos y nucleares (QBRN). Método: una revisión de alcance estructurada de acuerdo con las recomendaciones del JBI y la lista de verificación Elementos de informe preferidos para revisiones sistemáticas y la extensión Metanalyses para revisiones de alcance. El estudio se realizó en cinco etapas: búsqueda de fuentes en 17 bases de datos, un portal de información y dos repositorios de literatura gris, utilizando 125 descriptores DeCS, MeSH y Emtree, sin recorte temporal e idiomático; selección; lectura crítica de los textos seleccionados por dos revisores doble ciego; resumen de resultados y presentación de competencias mapeadas. Resultados: se analizaron 878 estudios, de los cuales 18 compusieron la muestra. En total, se mapearon 11 competencias, con énfasis en el dominio de formación técnica. Las competencias se refieren especialmente al conocimiento técnico-científico en situaciones de desastres que involucran a agentes QBRN y la seguridad de los pacientes y profesionales involucrados. Conclusión: la operacionalización de artificios para mejorar los procesos de calificación basados ​​en competencias demostró ser estratégica para aumentar la calidad y seguridad de las prácticas de transporte aéreo de pacientes. El abordaje de las fuentes sobre aspectos específicos de las particularidades de las prácticas relacionadas con emergencias y desastres que involucran a agentes QBRN en los procesos de formación/capacitación demuestra el esfuerzo académico por promover la reducción del riesgo de estos eventos cuando, en su momento, se activan las instituciones civiles y militares y sus operadores de salud.

RESUMO Objetivo: mapear as competências desenvolvidas em estratégias de capacitação para práticas de transporte aéreo de pacientes, diante de situações de emergência e desastres envolvendo agentes químicos, biológicos, radiológicos e nucleares (QBRN). Método: revisão de escopo estruturada conforme as recomendações do Joanna Briggs Institute e do checklist Preferred Reporting Items for Systematic reviews and Metanalyses extension for Scoping Reviews. O estudo foi desenvolvido em cinco etapas: busca de fontes em 17 bases de dados, um portal de informação e dois repositórios de literatura cinzenta, utilizando 125 descritores DeCS, MeSH e Emtree, sem recorte temporal e idiomático; seleção; leitura crítica na íntegra dos textos selecionados por dois revisores em duplo cego; síntese dos resultados e apresentação das competências mapeadas. Resultados: foram analisados 878 estudos, dos quais 18 compuseram a amostra. Ao todo, foram mapeadas 11 competências, com destaque para o domínio capacitação técnica. As competências referem-se especialmente ao conhecimento técnico-científico em situações de desastre envolvendo agentes QBRN e à segurança do paciente e dos profissionais envolvidos. Conclusão: a operacionalização de artifícios para aperfeiçoar os processos de capacitação baseados em competências mostrou-se estratégica para elevar a qualidade e a segurança das práticas de transporte aéreo de pacientes. A abordagem das fontes sobre aspectos específicos das particularidades das práticas relacionadas às emergências e desastres envolvendo agentes QBRN em processos de formação/capacitação demonstra o esforço acadêmico de promover a redução do risco desses eventos quando, oportunamente, forem acionadas instituições civis e militares e seus operadores de saúde.

Training of nursing in chemical, biological, radiological and nuclear defense for aeromedical evacuation in the pandemic.

OBJECTIVE: To describe the training of the military nursing team in chemical, biological, radiological, and nuclear defense to perform Aeromedical Evacuation in the coronavirus pandemic. This is an experience report about the training of the military nursing team in the Brazilian repatriation mission in China. Four members made up the aerospace nursing team. The period was from February to March 2020. Data analysis was carried out based on the survey of courses that each member of the nursing team had participated before the Operation. RESULTS: Training proved to be essential to meet the specificities of the mission. CONCLUSIONS: It is extremely important to operationalize protocols to improve the aeromedical service and transport mechanism, increasing the level of proficiency in the execution of missions. The training of the team allows the construction of necessary knowledge and skills during an aeromedical evacuation, guaranteeing the performance excellence required in this type of mission.

Air Evacuation of Citizens During the COVID-19 Epidemic.

BACKGROUND: The coronavirus epidemic originated in China, having its epicenter in Wuhan. This was the first place in the world to adopt social distancing measures to contain the disease on January 23rd, 2020. After the initial isolation, several countries started making diplomatic plans to evacuate and repatriate their citizens, with the permission of the Chinese authorities. Due to the high risk of exposure of the transported passengers, evacuations were conducted with preventive measures against contamination by biological agents.CASE REPORT: We report the air evacuation of 39 passengers from China to Brazil. Five passengers were transported to Poland and the remaining 34 went to Brazil, where they remained in quarantine for 14 d. The mission was triggered on February 4th, named "Operation Return to Brazil" (Operação Regresso à Pátria Amada Brasil), and conducted by military personnel of the Brazilian Air Force. The mission was accomplished in 6 days; the flight from Wuhan lasted 25 h 20 min; and, additionally, there were on-ground preparations.DISCUSSION: Only with adequate isolation and protective measures was it possible to air evacuate the potentially contaminated passengers in the initial phase of the pandemic. Specific protective equipment (Personal Protective Equipment - PPE) is mandatory for missions in which the properties of the potentially contagious biological agent are not fully known, as was the case. Due to the risk of contamination of passengers and the likely evolution of the transport into an aeromedical evacuation, protocols stating the minimum safety conditions for this kind of patient transport must be followed, with consideration for the patient as well as the crew.Gomes ED, Ronconi MABR, Santos MB, Júnior PP, Franco AZP, Haberland DF, Borges LL. Air evacuation of citizens during the COVID-19 epidemic. Aerosp Med Hum Perform 2022; 93(2):94-98.

Training of nursing in chemical, biological, radiological and nuclear defense for aeromedical evacuation in the pandemic / Formación de enfermería en defensa química, biológica, radiológica y nuclear para la evacuación aeromédica en pandemia / Capacitação da enfermagem em defesa química, biológica, radiológica e nuclear para evacuação aeromédica na pandemia

ABSTRACT Objective: To describe the training of the military nursing team in chemical, biological, radiological, and nuclear defense to perform Aeromedical Evacuation in the coronavirus pandemic. This is an experience report about the training of the military nursing team in the Brazilian repatriation mission in China. Four members made up the aerospace nursing team. The period was from February to March 2020. Data analysis was carried out based on the survey of courses that each member of the nursing team had participated before the Operation. Results: Training proved to be essential to meet the specificities of the mission. Conclusions: It is extremely important to operationalize protocols to improve the aeromedical service and transport mechanism, increasing the level of proficiency in the execution of missions. The training of the team allows the construction of necessary knowledge and skills during an aeromedical evacuation, guaranteeing the performance excellence required in this type of mission.

RESUMEN Objetivo: Describir la formación del equipo de enfermería militar en defensa química, biológica, radiológica y nuclear para realizar Evacuación Aeromédica en la pandemia de coronavirus. Es un relato de experiencia de la formación del equipo de enfermería militar en la misión de repatriación brasileña en China. Cuatro miembros conformaron el equipo de enfermería aeroespacial. El período fue de febrero a marzo de 2020. El análisis de datos se realizó a partir de la encuesta de cursos que cada integrante del equipo de enfermería había participado antes de la Operación. Resultados: La formación resultó fundamental para cumplir con las especificidades de la misión. Conclusiones: Es sumamente importante operacionalizar protocolos para mejorar el servicio aeromédico y el mecanismo de transporte, aumentando El nivel de competencia en la ejecución de misiones. La formación del equipo permite la construcción de conocimientos y habilidades necesarias durante una evacuación aeromédica, garantizando la excelencia de desempeño requerida en este tipo de misiones.

RESUMO Objetivo: Descrever a capacitação da equipe de enfermagem militar na defesa química, biológica, radiológica e nuclear para realizar Evacuação Aeromédica na pandemia do coronavírus. Trata-se de um relato de experiência da capacitação da equipe de enfermagem militar na missão de repatriação dos brasileiros na China. Quatro membros compuseram a equipe de enfermagem aeroespacial. O período foi de fevereiro a março de 2020. A análise dos dados foi realizada a partir do levantamento dos cursos que cada integrante da equipe de enfermagem havia participado antes da Operação. Resultados: A capacitação demonstrou-se fundamental para atender as especificidades da missão. Conclusões: É de suma importância operacionalizar protocolos para aperfeiçoar o mecanismo de atendimento e transporte aeromédico, elevando o nível de proficiência na execução das missões. A capacitação da equipe, permite construir conhecimentos e habilidades necessários durante uma evacuação aeromédica, garantindo a excelência de desempenho requerida nesse tipo de missão.

Military Nursing in "Operation Return to Brazil": aeromedical evacuation in the coronavirus pandemic.

OBJECTIVE: to describe the experience of military nursing in "Operation Return to Brazil" in an aeromedical evacuation. METHOD: this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus. RESULTS: the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers. Final considerations: nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.

Military Nursing in "Operation Return to Brazil": aeromedical evacuation in the coronavirus pandemic / Enfermería militar en la "Operación Regreso a Brasil": evacuación aeromédica en la pandemia de coronavirus / Enfermagem Militar na "Operação Regresso ao Brasil": evacuação aeromédica na pandemia do coronavirus

ABSTRACT Objective: to describe the experience of military nursing in "Operation Return to Brazil" in an aeromedical evacuation. Method: this is an experience report of the nursing staff in the Aeromedical Evacuation of potentially-contaminated Brazilians who were in Wuhan, China, after the outbreak of the new coronavirus. Results: the report was constructed from nursing care performed in three stages: pre-flight, screening, and flight. Pre-flight care would include aircraft configuration and material prediction. In screening, the staff was concerned with being properly attired. In the health assessment of returnees, in-flight, attention was focused on Personal Protective Equipment handling to minimize the risk of contamination by prolonged contact with potentially-contaminated passengers. Final considerations: nursing was committed to planning all the actions of this mission, which was one of the longest, strenuous and unprecedented in the history of aeromedical transport in Brazil.

RESUMEN Objetivo: describir la experiencia de enfermería militar en la "Operación Regreso a Brasil" en una evacuación aeromédica. Método: este es un informe de experiencia del equipo de enfermería, en la evacuación aeromédica de brasileños potencialmente contaminados que se encontraban en Wuhan, China, después del brote del nuevo coronavirus. Resultado: el informe se construyó a partir de la atención de enfermería realizada en tres etapas: pre-vuelo, detección y vuelo. En el prevuelo, el cuidado incluyó la configuración de la aeronave y el pronóstico del material. En la evaluación, al equipo le preocupaba estar bien preparado. En la evaluación de la salud de los retornados, durante el vuelo, la atención se centró en el manejo de equipos de protección personal para minimizar el riesgo de contaminación por contacto prolongado con pasajeros potencialmente contaminados. Consideraciones finales: la enfermería se comprometió a planificar todas las acciones de esta misión, que fue una de las más largas, extenuantes y sin precedentes en la historia del transporte aeromédico en Brasil.

RESUMO Objetivo: descrever a experiência da enfermagem militar na Operação Regresso ao Brasil em uma evacuação aeromédica. Método: trata-se de um relato de experiência da equipe de enfermagem, na evacuação aeromédica dos brasileiros potencialmente contaminados que estavam em Wuhan, China, após o surto do novo coronavírus. Resultado: o relato foi construído a partir de cuidados de enfermagem realizados em três etapas: pré-voo, triagem e voo. No pré-voo, os cuidados incluíram a configuração da aeronave e a previsão do material. Na triagem, a equipe preocupou-se em estar devidamente aparamentada. Na avaliação de saúde dos repatriados, durante voo, concentrou-se a atenção no manejo dos Equipamentos de Proteção Individual para minimizar o risco de contaminação pelo contato prolongado, com passageiros potencialmente contaminados. Considerações finais: a enfermagem empenhou-se no planejamento de todas as ações dessa missão, que foi uma das mais longas, extenuantes e inéditas da história do transporte aeromédico do Brasil.