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.

Perspectives from military neonatal transport: past, present, and future.

This article traces the historical development of neonatal transport, from ancient Greek mythology to the modern era, with a particular focus on the contributions of U.S. military aviation. The narrative begins with early efforts in thermoregulation through stationary incubators and progresses to the pivotal role of aerial hospitals during World War II. Post-WWII, the establishment of neonatal transport services in New York and advancements in incubator technology set the stage for further innovation. The U.S. military's involvement in neonatal transport, initiated in the 1970s, witnessed significant milestones, including the adaptation of ECMO technology for air transport. The narrative unfolds through the lens of U.S. military neonatology in the Western Pacific, particularly at Clark Air Base. The article concludes with insights into the U.S. Indo-Pacific Command's neonatal transport mission, highlighting challenges faced during the SARS-CoV-2/COVID-19 pandemic and the development of specialized infection containment transport systems.

[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.

[Experience in development of deployment tools of medical evacuation stages].

Paper is devoted to the history of creation of various types of field installations of the tent, mobile medical units and facilities, the experience of their usage in combat. An analysis of approaches to medical support of troops and equipment of the medical service in accordance with the changing nature of military operations in the XX-XI centuries is performed. Description of several generations of means taken to supply is given.

[Providing medical care in the Leningrad hospitals during the Soviet-Finnish war of 1939-1940].

Leningrad Health Care was assigned a central role in medical care of wounded and sick during the Soviet-Finnish war during 1939-1940. The outbreak of war in Leningrad and its suburbs, as well as a number of settlements adjacent to the front-line rear areas, was deployed hospital bed net hospital base of the front. Medical institutions of Leningrad, serve the needs of the army and navy, were not uniform in its structure. They had different departmental subordination, as well as the nature and scope of tasks. During the period from December 1, 1939 to September 1, 1940 in Leningrad, has received 167 915 persons. In the City there was a range of institutions, where the wounded and sick have finished a course of treatment, as well as rehabilitated.

The history of organized medical transport in Minneapolis: 1867-1930.

When Minneapolis officially became a city in 1867, there were no hospitals or ambulance services within its limits. Four years later, in 1871, the first hospital in the city, Cottage Hospital, opened its doors to the public, shifting medical care from the family home to the hospital. The need then developed for organized medical transport. The period between 1880 and 1890 marked the beginning of limited ambulance service in Minneapolis. Over the next 40 years, many public and private institutions developed their own transport services. During that same time, skilled medical transport in which physicians and/or nurses went along on calls began, and the transport of patients transitioned from horse and wagon to motorized ambulances. These developments would set the stage for future innovations in Minneapolis' emergency medical system and ultimately improve patient care and survival.

[Role of the 33rd distributing evacuation station in medical-evacuational support of the troops during the Great Patriotic War].

This article is concerned with the arrangement of formation of the administration of 33rd distributing evacuation station and organization of its evacuation work of casualties from hospital bases of West front lines to the hospitals in back land and also the main tasks of its subunits and units. The way of hospital trains performance, the amount of the hauls during the years of the work, average duration of one haul and average speed in kilometers, the amount of transferred casualties including litters.

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.

[Brazilian Army nurses and transportation of the wounded: a challenge faced during World War II]. / Enfermeiras do Exército Brasileiro no transporte aéreo de feridos: um desafio enfrentado na 2a. Gerra Mundial.

This historic-sociologic study aims to analyse the challenges faced by the Brazilian Expeditionary Force's Air Transportation Nurses of the Army with the Theatre of Operations on the course of World War II. The primary source was comprised of a photograph from this time period and oral testimonies of those who participated in the conflict. Ideas by sociologist Pierre Bourdieu support the discussion. Results suggest that Brazilian nurses were challenged to transport the wounded without medical advice. We conclude that the challenge to fulfill the task imposed, which led to independent decision-making, gave confidence and autonomy to the ones already responsible for the transportation of the wounded.

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.

[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.

Aeromedical evacuation in the "Luftwaffe" from its origins until 1945.

Prior to WWII, Germany had little experience in aeromedical evacuation (AE) of the sick and wounded. The need for a specialized AE organization was recognized, organized, and used extensively on all fronts during WWII. Nearly 2.5 million casualties were transported by regular troop carriers and 11 specialized AE Units, which concentrated on the intensive care air transport of the seriously wounded, especially those with injuries of the brain, eyes, or jaw, thoracic or abdominal wounds, or gun-shot fractures. The AE Units were commanded by medical officers, most of whom were pilot-physicians, who had command jurisdiction over flying and line personnel as well as medical service personnel. The AE Units were equipped with both Junkers Ju-52s, which could carry up to 12 litter patients plus 3 to 5 ambulatory patients each, and with Fieseler Fi -156s (STOL "Stork" for 1 or 2 litter patients), ambulances, as well as the personnel needed for operating and maintaining the vehicles and materiel. The AE Units of the Luftwaffe--the Sanitaetsflugbereitschaften--made an outstanding contribution to military medical care in achieving this significant number of casualties evacuated under the humanitarian symbol of the Red Cross.