El origen del aerotransporte sanitario en España. Una historia olvidada de la Medicina de Urgencias / Earliest air ambulance flights in Spain: a forgotten part of the history of emergency medicine

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Neonatal Transport: Current Trends and Practices.

Since the inception of organized neonatal transport in the 1940s, advances in clinical care and technology have made the neonatal intensive care unit even more mobile in terms of care delivery. There currently exists an emphasis on quality metrics and simulation-based training for transport team members to achieve high levels of individual and team competence. Emerging therapies such as active cooling for neuroprotective hypothermia and high-frequency ventilation provide evidence-based care in the transport environment to enhance clinical outcomes. Accreditation of neonatal transport programs is now embraced as an indicator of competency and compliance with transport standards.

[The treatment of wounds during World War I].

The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases. In the first part of this article, we describe the surgical procedures and medical therapies carried out by Italian physicians during the First World War, with the aim of treating wounded soldiers in this pre-antibiotic era. Antibacterial solutions, such as those of Dakin-Carrel and sodium hypochlorite and boric acid, the tincture of iodine as well as the surgical and dressing approaches and techniques used to remove pus from wounds, such as ignipuncture and thermocautery or lamellar drainage are reported in detail. In the second part of the paper, the organization of the Italian military hospitals network, the systems and tools useful to transport wounded soldiers both in the front lines and in the rear is amply discussed. In addition, the number of soldiers enrolling, and those dying, wounded or missing during the Great War on the Italian front is estimated.

A Historical Perspective on the Transport of Premature Infants.

A premature newborn was first transported via helicopter from place of birth to a specialty nursery 50 years ago. Since that time, the care of high-risk and premature newborns has evolved, but specialized services are not always available at the birth site. As a result, the demand for newborn transfer continues to grow. Today, neonates are transported to tertiary centers via ground ambulances, helicopters, and airplanes by highly trained personnel using sophisticated incubators and equipment.

Innovación tecnológica y humanitarismo en el traslado de heridos de guerra: el informe de Nicasio Landa sobre un nuevo sistema de suspensión elástica de camillas (Pamplona, 29 mayo 1875) / Technological innovation and humanitarianism in the transport of war wounded: Nicasio Landa’ s report on a new elastic suspension system for stretchers (Pamplona, May 29, 1875)

Resumen En mayo de 1875, en medio de una sangrienta contienda civil en España conocida como Tercera Guerra Carlista, Nicasio Landa, oficial médico de Sanidad Militar redactó un informe demandando autorización a sus superiores para que Cruz Roja Española, de la que era inspector general, pudiera adoptar un nuevo sistema de suspensión elástica para camillas que había diseñado, desarrollado y probado. Destinado ante todo a carretas de labranza – el medio de transporte de heridos aún más frecuente entonces – se presentaba como un mecanismo económico y resistente para mejorar el confort de los trasladados, que podía también instalarse en carruajes de ambulancia, vagones de ferrocarril y buques-hospitales. Se publica una edición anotada del informe precedida de una presentación del mismo.

Abstract In May 1875, in the midst of a bloody civil conflict in Spain known as the Third Carlist War, Nicasio Landa, a medical officer with Military Health, wrote a report requesting authorization for the Spanish Red Cross, of which he was Inspector General, to adopt a new elastic suspension system for stretchers that he had designed, developed and tested. Intended above all for use in farm wagons – still the most widely-used method of transporting the wounded at the time – it was an inexpensive, sturdy mechanism that improved patient comfort and could also be installed in ambulance carriages, railway carriages and hospital ships. An annotated version of the report is included, preceded by a presentation of its contents.

[Technological innovation and humanitarianism in the transport of war wounded: Nicasio Landa's report on a new elastic suspension system for stretchers (Pamplona, May 29, 1875)]. / Innovación tecnológica y humanitarismo en el traslado de heridos de guerra: el informe de Nicasio Landa sobre un nuevo sistema de suspensión elástica de camillas (Pamplona, 29 mayo 1875).

In May 1875, in the midst of a bloody civil conflict in Spain known as the Third Carlist War, Nicasio Landa, a medical officer with Military Health, wrote a report requesting authorization for the Spanish Red Cross, of which he was Inspector General, to adopt a new elastic suspension system for stretchers that he had designed, developed and tested. Intended above all for use in farm wagons - still the most widely-used method of transporting the wounded at the time - it was an inexpensive, sturdy mechanism that improved patient comfort and could also be installed in ambulance carriages, railway carriages and hospital ships. An annotated version of the report is included, preceded by a presentation of its contents.

Pediatric transport medicine and the dawn of the pediatric anesthesiology and critical care medicine subspecialty: an interview with pioneer Dr. Alvin Hackel.

Dr. Alvin 'Al' Hackel (1932-) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology ('who is a pediatric anesthesiologist?') and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. His enduring impact on pediatric anesthesia and critical care practice was recognized in 2006 by the American Academy of Pediatrics when it bestowed upon him the profession's highest lifetime achievement award, the Robert M. Smith Award. Of his many contributions, Dr. Hackel identifies his early involvement in the development of pediatric transport medicine as well as the subspecialty of pediatric anesthesiology as his defining contribution. Based on a series of interviews held with Dr. Hackel between 2009 and 2014, this article reviews the early development of transportation medicine and the remarkable career of a pioneering pediatric anesthesiologist.

[Organization of medical support for troops, defending Leningrad and the people of the blockaded city].

The data on the composition of forces of medical services and organization of medical-evacuation support for troops defending the blockaded Leningrad are presented. The information about the health losses among the population of Leningrad as a result of bombing, shelling and disease is given. Extremely high rates of morbidity and mortality in residents were associated with hunger, hypothermia and emotional stress. The clinical picture of some diseases has different peculiarities because of alimentary dystrophy background. The city health service suffered huge losses: 482 medical institutions were destroyed, only about 300 people from 1.5 thousand of medical personnel in 1942 saved working capability. The health care service of the local air defense played an essential role in delivery of medical aid. The contribution of civil and military health workers in saving residents lives in the blockaded Leningrad was appreciated.

[Medical support of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front].

Prussian offensive operation performed by the 2nd Belorussian Front. An activity of the medical An activity of the medical service of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front is a typical example of the medical support of troops during the final stages of World War II. Forms and methods of medical support management, which were developed during the war, haven't lost their importance in modern conditions. These methods include the establishment of specialized surgical and therapeutic field hospital, establishment of medical institutions in the Army, which worked on the evacuation directions and reserve of mobile hospitals and transport, timely extension of the first echelons of the hospital base front to change institutions hospital deployed the army base. A research of experience in organizing medical support of the offensive operations performed during the last year of World War II provides the material for the development of the theory of modern medical support operations and ability to provide on this basis, the continuity of the hospitals, the continuity of qualified and specialized medical care, improve the performance of diagnostic and treatment work.

Aspectos históricos do transporte aeromédico e da medicina aeroespacial - revisão / Historical aspects of aeromedical transportand aerospace medicine – review

A história do transporte aeromédico e da Medicina Aeroespacial consiste em agradável viagem ao passado, com grandes perspectivas. Este trabalho descreve como a Medicina militar e as guerras trouxeram conhecimentos sobre a fisiologia humana, contribuindo para o desenvolvimento de várias áreas médicas. A viagem inicia-se na mitologia grega, com Dédalus e Ícaro, passando pelos balões inicialmente sem direção, depois seus dirigíveis, até chegar às máquinas voadoras mais pesadas que o ar. O homem experimentou ambiente hostil que lhe era desconhecido; a baixa pressão atmosférica, a hipóxia e a hipotermia eram apenas o começo. Paul Bert, médico fisiologista e pai da Medicina Aeroespacial, já realizava estudos em câmara hipobárica, mesmo com toda limitação tecnológica da época. Nascia nova era, em que o homem começava a entender e a dominar as alterações fisiológicas da altitude.A concepção de transporte aeromédico foi introduzida durante as guerras napoleônicas e sedimentada na Guerra Franco-Prussiana (1871), quando 160 feridos foram transportados da Paris sediada, em balões de ar quente. A grande evolução nos cuidados pré-hospitalares e no modelo de remoção de pacientes ocorreu durante as Guerras do Vietnã e da Coreia,palco de estrutura que serviu de molde para os sistemas de atendimento ao trauma da atualidade. As guerras continuam a assolar a humanidade, levando vidas e trazendo sofrimento e dor aos que ficam. Paradoxalmente, é a mesma guerra que fornece condições de pesquisae desenvolvimento de inventos e tecnologia, as quais propulsionaram a conquista de novos universos. O caminho é literal. Vai da imaginação da mitologia grega em possibilitar ao homem voar, até a da atualidade, que faz sonhar em conquistar o espaço, com a mesma personalidade desbravadora que dos antecessores. Aqui o céu não é o limite.

The history of aeromedical transport and Aerospace Medicine consists in a pleasant journey to the past, with great prospects. This article describes how military medicine and wars advanced our understanding of human physiology, contributing to the development of various medical s. The journey begins in Greek mythology, with Daedalus and Icarus, moving on to balloons, then on to airships, until we reach heavier than air flying machines. Man experienced a hostile environment unknown to him, low atmospheric pressure, hypoxia and hypothermia were just the beginning.Paul Bert, medical physiologist and father of Aerospace Medicine, already performed studies in hypobaric chambers, even with all the technological limitations of his time. A new era was born, in which man began to understand and master the physiological changes of altitude. The concept of aeromedical transport was introduced during the Napoleonic wars and consolidated in the Franco-Prussian War (1871), when 160 wounded men were transported from sieged Paris on hot air balloons. A great evolution in pre-hospital care and patient evacuation strategies occurred during thewars in Vietnam and Korea, stages that served as a templates for the structures of trauma care today. Wars continue to ravage humanity, taking lives and bringing pain and suffering to those who remain. Paradoxically,it is the same war that provides conditions for research and development of inventions and technology, which propelled the conquering of new worlds. The path is literal. It goes from the ingenuity of Greek mythologythat enabled man to fly, to today, making us dream of conquering space, with the same adventurous personality of our predecessors. Here, the sky is not the limit.

[Treatment organization for patients with gunshot wounds of the maxillo-facial region evacuated during the military operations in the Far East (1938-1939) and the war with Finland (1939-1940)].

This article describes the path of the maxillo-facial surgery to becoming an independent part of the general surgery. We will look closely at the experience, gained y field surgeons during the events at Lake Hasan and Halkin-Gol river. The war with Finland, that enabled the surgeons to develop the system of specialized dental help for the gunshot wounds, to create standarts of specialized equipment, examples of splints, etc, which were widely used during the World War II.

[From South Tyrol to Württemberg: the "resettlement" of South Tyrolean psychiatric patients within the Germano-Italian Option Agreement of 1939]. / Von Südtirol nach Württemberg. Die "Umsiedlung" südtiroler psychiatriepatienten im Rahmen des deutsch-italienischen Optionsvertrages ab 1939.

Object of this article is the procedure of the transport of South Tyrol patients to the South Wuerttemberg asylums Zwiefalten und Schussenried as well as to some extent to the former asylum of Weissenau near Ravensburg in 1940 and 1942. Attention is focused on the pioneering state pre-negotiations, the so-called option treaties between the German Reich and Fascist Italy as part of the general aspect of National Socialist bio-Politics.The treatment of these South Tyrol patients in the asylums themselves, as well as their fate will be put into the context of the resettlement actions at the margins of the "Third Reich", which started in 1939 and widely affected the European continent. By presenting the abuse of medical patients in the aim to solve the political problems having occurred after bio-political goals had been set into practice, this study offers new material to the history of National Socialist psychiatry, as well as to National Socialist Foreign Policy in the case of Italy.