A Program Profile of Air Medical Transport in Regional Central Queensland, Australia
ConclusionAir medical transports are an integral part of the health system in Central Queensland communities with vast geographic distances. Identifying regional referral pattern rates and ratios aid in the planning of resource allocation. (Source: Air Medical Journal)
Source: Air Medical Journal - October 23, 2019 Category: Emergency Medicine Source Type: research

Mechanical Ventilation: Finer Points
Publication date: Available online 19 October 2019Source: Air Medical JournalAuthor(s): David J. Dries (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Forum November/December 2019
Publication date: Available online 19 October 2019Source: Air Medical JournalAuthor(s): (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

The Neonatal Transporter's Brain
Publication date: Available online 18 October 2019Source: Air Medical JournalAuthor(s): Carlo Bellini (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Infrastructure
Publication date: Available online 18 October 2019Source: Air Medical JournalAuthor(s): Eileen Frazer (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Convulsion Treated by a Physician-Staffed Helicopter
ConclusionThe present study indicated the usefulness of a physician-staffed helicopter for treating convulsive patients at the scene. (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Extracorporeal Membrane Oxygenation in Transport Part 2: Complications and Troubleshooting
Publication date: Available online 19 October 2019Source: Air Medical JournalAuthor(s): Jennifer Vieira, Michael Frakes, Jason Cohen, Susan WilcoxAbstractFactors taken for granted while the extracorporeal membrane oxygenation (ECMO) patient is maintained in a hospital setting can become critical when planning for transport. These issues include but are not limited to positioning of patients on a small transport stretcher, positioning of cannulas and equipment, ensuring adequate power sources and supply, inefficient temperature control, and a much higher risk of decannulation. It is paramount to be comfortable with the mana...
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Postpartum Hemorrhage With Cardiorespiratory Collapse Transported From a Rural Hospital
Publication date: Available online 19 October 2019Source: Air Medical JournalAuthor(s): Chad L. Ulrich, Richard B. Utarnachitt, Kyle Danielson, Alexa Pieri, Steven Whitley, Andrew J. Latimer (Source: Air Medical Journal)
Source: Air Medical Journal - October 20, 2019 Category: Emergency Medicine Source Type: research

Articles That May Change Your Practice: Dexmedetomidine
Publication date: Available online 16 October 2019Source: Air Medical JournalAuthor(s): Russell D. MacDonald, Adam Greene (Source: Air Medical Journal)
Source: Air Medical Journal - October 17, 2019 Category: Emergency Medicine Source Type: research

CAMTS Quality Management Process
Publication date: Available online 17 October 2019Source: Air Medical JournalAuthor(s): Eileen Frazer (Source: Air Medical Journal)
Source: Air Medical Journal - October 17, 2019 Category: Emergency Medicine Source Type: research

A Blended Prehospital Ultrasound Curriculum for Critical Care Paramedics
ConclusionThe implementation of a prehospital critical care ultrasound program is feasible in our provincial emergency medical services system. Further assessment is necessary to determine future knowledge and skill retention as well as clinical application and utility in real-world settings. (Source: Air Medical Journal)
Source: Air Medical Journal - October 3, 2019 Category: Emergency Medicine Source Type: research

Effect of Suction Assisted Laryngoscopy Airway Decontamination (SALAD) Training on Intubation Quality Metrics
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): Matt Jensen, Amir Louka, Benjamin BarmaanIntroductionVCU Health Critical Care Transport Network paramedics and nurses staff three rotary-wing aircraft and one ground ambulance that provide scene response and interfacility transports throughout Virginia. Prehospital rapid sequence induction and intubation are among the highest risk procedures employed by these providers, particularly when the airway is massively contaminated with blood or vomit. A quality assurance review of attempted prehospital intubations determined is...
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

Table of Contents
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

Editorial Board
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

General Information
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

The Glucose Connection: Field Hyperglycemia as an Early Predictor of Hypotension in Trauma Patients
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): Joseph Hill, Michelle McLean, Dave GothardIntroductionTrauma is the fourth leading cause of death overall for all ages and identifying a preemptive surrogate parameter that indicates impending shock would allow for optimization of prehospital care.Stress induced hyperglycemia (SIH) occurs secondary to critical illness or injury. Research indicates that SIH is a predictor of mortality in critically ill patients. Multiple studies have indicated a positive correlation between admission hyperglycemia and hypotension in traum...
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

Improving Transport Safety by Limiting Driver Duty Hours Utilizing Simulation to Optimize Team Schedules
ConclusionSafety must always be our top priority in transport for our patients and crew. Implementing a driver duty hour policy was an important step in address safety issues related to driver fatigue when the risk is highest at the end of a long shift. Implementing a simulation tool allowed us to test scheduling combinations that would allow us to minimize times our team would be required to work over there expected shift and maximize the availability of our team. (Source: Air Medical Journal)
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

The SHOCK of Sepsis
ConclusionIn conclusion, the attendee will have a better understanding of the signs and symptoms of sepsis, the importance of early recognition and timely treatment to decrease the mortality due to sepsis in the pediatric population. (Source: Air Medical Journal)
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

A Systematic Approach to Ventilator Management for the Pediatric Patient during Air Medical Transport
Publication date: September–October 2019Source: Air Medical Journal, Volume 38, Issue 5Author(s): Chris StansellObjectiveA checklist was developed to improve the ventilator management of pediatric patients for AeroCare. Aims: Reduce the percentage of patients outside recommended parameters (no bag-valve mask use, SpO2 level> 90%, and EtCO2 level>35 and 5 kg and
Source: Air Medical Journal - October 2, 2019 Category: Emergency Medicine Source Type: research

An Apple a Day: Modern Atrial Fibrillation Detection
Publication date: Available online 27 September 2019Source: Air Medical JournalAuthor(s): Joseph Hill, Peter Tilney (Source: Air Medical Journal)
Source: Air Medical Journal - September 27, 2019 Category: Emergency Medicine Source Type: research

Assessment of Pain Management During Interfacility Air Medical Transport of Intubated Patients
The objective of the current study was to determine the proportion and frequency of opioid analgesia provided to intubated patients during interfacility transport by an air medical transport system.MethodsThis was a health records review examining electronic records of intubated patients transported by Ornge from July 2015 to November 2015. Cases were identified using Ornge database, and intubated patients were selected based on the inclusion criteria. A standardized data extraction form was piloted and used by a single trained data extractor. The primary outcome was whether analgesia was provided. Secondary outcomes inclu...
Source: Air Medical Journal - September 25, 2019 Category: Emergency Medicine Source Type: research

Critical Care Helicopter Overtriage: A Failure Mode and Effects Analysis
Conclusion: Associated factors for interfacility HEMS OT, downstream effects, and areas for change were identified. EMP and emergency medical services practices, HEMS processes, and shared decision making may affect regional OT rates. (Source: Air Medical Journal)
Source: Air Medical Journal - September 19, 2019 Category: Emergency Medicine Source Type: research

Resuscitation Part 2: Trauma and Burn Injury
Publication date: Available online 24 August 2019Source: Air Medical JournalAuthor(s): David J. Dries (Source: Air Medical Journal)
Source: Air Medical Journal - August 26, 2019 Category: Emergency Medicine Source Type: research

Prove It
Publication date: Available online 17 August 2019Source: Air Medical JournalAuthor(s): John R. Clark (Source: Air Medical Journal)
Source: Air Medical Journal - August 17, 2019 Category: Emergency Medicine Source Type: research

Renal Injuries, Markers, and Therapy
Publication date: Available online 9 August 2019Source: Air Medical JournalAuthor(s): Anna Rauzi, David J. Dries (Source: Air Medical Journal)
Source: Air Medical Journal - August 10, 2019 Category: Emergency Medicine Source Type: research

Articles That May Change Your Practice: Sugammadex
Publication date: Available online 9 August 2019Source: Air Medical JournalAuthor(s): Russell D. MacDonald (Source: Air Medical Journal)
Source: Air Medical Journal - August 10, 2019 Category: Emergency Medicine Source Type: research

Forum September/October 2019
Publication date: Available online 7 August 2019Source: Air Medical JournalAuthor(s): (Source: Air Medical Journal)
Source: Air Medical Journal - August 8, 2019 Category: Emergency Medicine Source Type: research

2019 Air Medical Transport Conference Scientific Assembly Abstracts
Publication date: Available online 2 August 2019Source: Air Medical JournalAuthor(s): (Source: Air Medical Journal)
Source: Air Medical Journal - August 4, 2019 Category: Emergency Medicine Source Type: research

2019 Air Medical Transport Conference Preview
Publication date: Available online 2 August 2019Source: Air Medical JournalAuthor(s): Natasha J. Ross (Source: Air Medical Journal)
Source: Air Medical Journal - August 4, 2019 Category: Emergency Medicine Source Type: research

Pericardiocentesis in an Ambulance: A Case Report and Lessons Learned
We report a case in which lifesaving pericardiocentesis was performed in the back of an ambulance after temporizing measures of volume resuscitation and vasopressor therapy failed.Fluid accumulation within the pericardial sac can increase pressures around the heart and lead to cardiac tamponade. Helicopter emergency medical service crews may be called to transport patients with cardiac tamponade physiology to definitive care where removal of the pericardial fluid can be achieved. Pericardiocentesis is indicated as an emergency procedure in patients with hemodynamic compromise secondary to cardiac tamponade.1 Because most H...
Source: Air Medical Journal - July 27, 2019 Category: Emergency Medicine Source Type: research

Review of Literature for Air Medical Evacuation High-Level Containment Transport
ConclusionsLimited peer-reviewed literature exists on AE-HLCT, including important aspects related to healthcare worker fatigue, alertness, shift scheduling, and clinical care performance. This hinders the sharing of best practices to inform evacuations and equip teams for future outbreaks. Despite the successful use of different aircraft and technologies, the unique nature of the mission opens the opportunity for greater coordination and development of consensus standards for AE-HLCT operations. (Source: Air Medical Journal)
Source: Air Medical Journal - July 19, 2019 Category: Emergency Medicine Source Type: research

Controlled Substances Compliance for Transport Programs
This article serves to lift the regulatory fog surrounding controlled substances and to provide clear and actionable guidance to transport programs. Storage, security, and recordkeeping requirements for emergency medical service organizations can be confusing given that there are no specific regulations for emergency medical services. Transport programs are subject to all the current regulations, and nonadherence can result in significant fines and loss of public trust for any transport program found to be in violation. (Source: Air Medical Journal)
Source: Air Medical Journal - July 19, 2019 Category: Emergency Medicine Source Type: research

Medical Protocols
Publication date: Available online 16 July 2019Source: Air Medical JournalAuthor(s): Eileen Frazer (Source: Air Medical Journal)
Source: Air Medical Journal - July 17, 2019 Category: Emergency Medicine Source Type: research

First Reported Helicopter In-flight Serratus Plane Block for Rib Fractures
Publication date: Available online 17 July 2019Source: Air Medical JournalAuthor(s): Justin McLean, Sean Cooke, Brian Burns, Cliff Reid (Source: Air Medical Journal)
Source: Air Medical Journal - July 17, 2019 Category: Emergency Medicine Source Type: research

Prehospital Airway Management in Severe Traumatic Brain Injury
ConclusionsLiterature about this topic is still inconclusive; however, new evidence taking into consideration more complex aspects of airway management rather than orotracheal intubation per se shows improved outcomes with aggressive prehospital airway management. (Source: Air Medical Journal)
Source: Air Medical Journal - July 13, 2019 Category: Emergency Medicine Source Type: research

First-Pass Success Intubations Using Video Laryngoscopy Versus Direct Laryngoscopy: A Retrospective Prehospital Ambulance Service Study
ConclusionThis retrospective study shows that video laryngoscopy had a higher first-pass success rate than direct laryngoscopy. This is promising because decreasing failure rates provide better patient outcomes. (Source: Air Medical Journal)
Source: Air Medical Journal - July 13, 2019 Category: Emergency Medicine Source Type: research

Neonatal Transport Clinician Performed Ultrasound Evaluation of Cardiac Function
ConclusionNeonatal RNs and RTs can be trained to perform focused cardiac ultrasound examinations with average time of 8.6 hours. This skill could enhance clinical care on neonatal transport with appropriate interventions to manage suspected hypotension or shock. (Source: Air Medical Journal)
Source: Air Medical Journal - July 11, 2019 Category: Emergency Medicine Source Type: research

Factors Affecting Stabilization Times in Neonatal Transport
Publication date: Available online 9 July 2019Source: Air Medical JournalAuthor(s): Muzafar Gani Abdul Wahab, Sumesh Thomas, Prashanth Murthy, Aravanan Anbu ChakkarapaniAbstractObjectiveDuring transport, the time spent in stabilizing sick infants before repatriation is crucial in optimizing the outcome and effective use of resources. The study aim was to assess individual components of neonatal transport time to identify opportunities to minimize delay, optimize care, and improve the overall efficiency of transport.MethodsA single-center prospective observational study conducted at McMaster Children's Hospital, Hamilton, O...
Source: Air Medical Journal - July 10, 2019 Category: Emergency Medicine Source Type: research

Table of Contents
Publication date: July–August 2019Source: Air Medical Journal, Volume 38, Issue 4Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Editorial Board
Publication date: July–August 2019Source: Air Medical Journal, Volume 38, Issue 4Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

General Information
Publication date: July–August 2019Source: Air Medical Journal, Volume 38, Issue 4Author(s): (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Abstract 2: Cardiac Arrest During Aeromedical Transport: A 5-year Retrospective Case Review
ConclusionsIn this cohort, OHCA occurred in 92 adult patients over 5 years, with approximately two thirds medical and one third traumatic in nature. Initial rhythm was rarely shockable, but sustained ROSC was achieved in almost half the patients. Almost 4 in 10 patients had multiple cardiac arrests under AEMS care, and initial arrest was most likely to occur prior to air transport as opposed to in flight. A high proportion of patients achieving ROSC is possible, even with relatively low rates of shockable initial rhythm. This study suggests that while cardiac arrest in flight is rare, medical teams must be prepared to hand...
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Abstract 3: Comparison of Flight Physician operated Hyper-Angulated and Standard Geometry Video Laryngoscopy Tracheal Intubation on a Helicopter in a Manikin
Conclusions/LimitationsOur results suggest that both SAVL and HAVL are efficacious techniques to perform intubations in an EC-135 helicopter, should this somewhat rare, but likely difficult procedure, be necessary. Providers did, however, prefer HAVL over SGVL in our group. The discordant quantitative and qualitative results in this study may be due to the static nature and highly favorable anatomy of a manikin, versus the varying anatomy of individual patients. (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Abstract 4: Predictors of Definitive Airway sans Hypoxia/Hypotension on First Attempt (DASH 1A) Success in Traumatically Injured Patients Undergoing Prehospital Intubation
ConclusionsIn our helicopter EMS system, successful endotracheal intubation on the first attempt and without an episode of hypoxia was associated with no ground EMS intubation attempt prior to flight crew arrival, lack of airway secretions, Cormack-Lehane Score, and bougie use. (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Abstract 5: Prevalence, Characteristics, and Accuracy of Stroke Diagnosis for Scene Transports to a Comprehensive Stroke Center by Helicopter Emergency Medical Services: A One Year Retrospective Evaluation
Publication date: July–August 2019Source: Air Medical Journal, Volume 38, Issue 4Author(s): Ekta Panjrolia, Anne Jackson, Stacie Stevens, Lorie Selleck, V. Ramana Feeser, Bert Bogue, Kathy Baker, Harinder DhindsaIschemic strokes affect 795,000 people per year in the US and are a major cause of long-term disability and mortality. These patients are often assessed by EMS at the scene and transported to appropriate centers of care for further evaluation and treatment. Utilization of helicopter emergency medical services (HEMS) greatly improves access to comprehensive stroke centers (CSC). However, the number of patients...
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Abstract 1: Analysis of the Usage of a Portable X-Ray System Transported to the Scene by a Physician-Staffed Helicopter
ConclusionThis is the first study to demonstrate that the performance of X-ray studies at the scene did not significant influence the activities of DH staff and to demonstrate that X-ray studies were performed significantly more frequently when a DH was dispatched to the scene. Future prospective studies involving a greater number of patients and a comparison of the final outcomes are needed. (Source: Air Medical Journal)
Source: Air Medical Journal - June 25, 2019 Category: Emergency Medicine Source Type: research

Cognitive Appraisal and Stress Performance: The Threat/Challenge Matrix and Its Implications on Performance
Publication date: Available online 13 June 2019Source: Air Medical JournalAuthor(s): John vonRosenbergAbstractBackgroundStress has the potential to improve performance through increased focus and strength or negatively impact performance through distraction and decreased fine motor control. The first step in the distinction between success or failure in a stressful situation is making the decision to engage in the process or withdraw. Cognitive appraisal describes the process of evaluating a stimulus as either a challenge to be met or an overwhelming obstacle from which to retreat.ObjectiveProviders in the air medical comm...
Source: Air Medical Journal - June 13, 2019 Category: Emergency Medicine Source Type: research

Forum July/August 2019
Publication date: Available online 3 June 2019Source: Air Medical JournalAuthor(s): (Source: Air Medical Journal)
Source: Air Medical Journal - June 4, 2019 Category: Emergency Medicine Source Type: research

Resilience During Times of Change
Publication date: Available online 3 June 2019Source: Air Medical JournalAuthor(s): Eileen Frazer (Source: Air Medical Journal)
Source: Air Medical Journal - June 4, 2019 Category: Emergency Medicine Source Type: research

The Concept of Overcommitment in Rescue Operations: Some Theoretical Aspects Based on Empirical Data
ConclusionAir ambulance personnel recognize overcommitment in a variety of situations. They broaden the concept to include both regular, everyday actions and hazardous rescue attempts in extraordinary incidents. The causal factors form recognizable constellations that may offer useful starting points for systems-based counteracting measures. The definition of overcommitment could provide a background for evaluation and learning in the rescue service. (Source: Air Medical Journal)
Source: Air Medical Journal - May 26, 2019 Category: Emergency Medicine Source Type: research