Air Medical Journal via MedWorm.com

Hypertrophic Pyloric Stenosis: It Can Take Your Breath Away

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Hypertrophic pyloric stenosis (HPS) is a cause of vomiting in infants. Classically, infants with HPS present with nonbilious projectile vomiting resulting from progressive gastric outlet obstruction. Depending on the duration of symptoms, patients may present with dehydration or metabolic alkalosis. The mortality associated with HPS was as high as 14.4% in 1935, but improved to 0.5% in the late 1960s, where it has held at 0.4% in the modern era. A clear pathophysiologic understanding of HPS has been evasive, although the hypertrophied pylorus likely occurs as a downstream consequence of postnatal physiologic changes, abnormal pyloric innervations, genetic mutation(s), and unknown environmental influences. Scant reports of apnea in patients with pyloric stenosis occur in the literature. Her...

Myocardial Infarction Complicated by Ventricular Septal Rupture

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

This article describes such a transport and reviews the pathophysiology of the process along with treatment options. (Source: Air Medical Journal)

Medical Flight Crew Perceived Work-Related Musculoskeletal Symptoms and Related Characteristics

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: Age-related differences were believed to be a factor that contributed to more musculoskeletal complaints for older flight crewmembers; however, the data from this study only partially support that hypothesis. Flight crewmembers face a number of unique challenges that require maintaining physical strength and endurance. (Source: Air Medical Journal)

Propofol Infusion for the Retrieval of the Acutely Psychotic Patient

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Discussion is also presented on the potential utility of propofol for the retrieval of acutely psychotic patients. (Source: Air Medical Journal)

Hypoxia Symptoms during Altitude Training in Professional Iranian Fighter Pilots

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: Susceptibility ot hypoxia increases with pilot age. (Source: Air Medical Journal)

CCTMC Goes Back to Music City for 20th Anniversary

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

You won't want to miss the 2012 Critical Care Transport Medicine Conference (CCTMC), to be held April 2-4 at the Loews Vanderbilt Hotel in Nashville—a premier critical care transport education opportunity. Join your peers for a spectacular 20th celebration. Find out who has attended every CCTMC and who has presented the most times. Bring photos of past conferences to share with the group. (Source: Air Medical Journal)

The MedEvac

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Into the blue, the black, the grey Into the skies of night, of day To cities, mountains, the towns big and small The Medevac goes to answer the call When lives hang in the balance, needing critical care These selfless providers quickly take to the air Expertly trained for their work, with skills tried and true They are the elite, the Air Medical Flight Crew Collective sighs of relief, when they arrive Heard softly through prayers, “Keep this patient alive.” Then they race through the sky, cheating death once again To the specialty care on this flight's other end Yet, sadly we know, these crews don't always come home This mission tonight is their final one flown On their way back, something went terribly wrong No...

Certification Review

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

In which of the following conditions would you expect to see a delta wave? (Source: Air Medical Journal)

Concern Network

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

The Concern Network shares verified information to alert medical transport programs when an accident/incident has occurred. Both air and ground programs are encouraged to participate. If you have questions, contact CONCERN Coordinator David Kearns at (800) 525 3712 or www.concern-network.org. (Source: Air Medical Journal)

Forum

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

As I sit down to write to all of my fellow air medical and critical care transport professionals, it strikes me that this is a significant point in our “comindustry.” We have all recounted our history as to how AAMS and our comindustry have evolved to this juncture; what I want to write to you about is how we craft our future together. AAMS is at a crucial juncture in its progression, as our long-term executive director, Dawn Mancuso, has accepted a leadership position with another association, and we are engaged in a search to identify and bring on board a new CEO, a leader for our association. This will occur possibly as soon as the 2012 second quarter. (Source: Air Medical Journal)

Rocuronium Versus Succinylcholine for Rapid Sequence Intubation

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Seupaul RA, Jones JH. Does succinylcholine maximize intubating conditions better than rocuronium for rapid sequence intubation? Ann Emerg Med. 2011;57:301-2. Strayer RJ. Rocuronium versus succinylcholine: Cochrane synopsis reconsidered. (Corr.) Ann Emerg Med 2011;58:217-8. (Source: Air Medical Journal)

The Smoking Gun: Patient Confidentiality

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

We departed the chaotic scene and within minutes were landing to deliver our patient to the trauma team. My partner needed a cigarette and left me to clean up as he walked outside for a smoke and directly into the microphones of the media. Intent on turning the patient we had transported into the breaking news story of the afternoon, the media asked some basic questions that he answered—condition, prognosis, injuries—and he walked away from the cameras. We buttoned everything up and flew back to our base, where we were met on the helideck by the program director and a very unhappy administrator. (Source: Air Medical Journal)

Blast Lung Injury in a 20-Year-Old Man after a Home Explosion

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

A large family home exploded after a propane leak ignited. Initial reports from the scene noted that 11 people were injured, with many sustaining critical injuries. Immediately, multiple helicopter emergency medical services aircraft were dispatched to respond to the scene, and ground emergency medical services (EMS) providers were en route. Of the five aircraft requested, only two were available to respond; one aircraft was out for maintenance, and two others were committed to other missions. (Source: Air Medical Journal)

Experimental Studies in Air Medical Research

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

This article is the 18th in a multipart series designed to assist readers, particularly novices, in the area of clinical research. This article is focused on the process of developing a new research project. It provides tools to help those involved in beginning their own research projects. (Source: Air Medical Journal)

Human Patient Simulators

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

The Commission on Accreditation of Medical Transport Systems (CAMTS) accreditation standards, since the first edition, have specified initial and ongoing education criteria for medical personnel. In recent years, as there are more and more medical transport services that are not affiliated with hospitals, the standard that requires ongoing clinical experiences has been more difficult to achieve. Legal and contractual issues are involved when private services try to contract with a hospital for clinical experiences, and the CAMTS board understands these issues. (Source: Air Medical Journal)

General Information

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Air Medical Journal ISSN (1067-991X) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are January, March, May, July, September, and November. Business and Editorial Offices: 1600 John F. Kennedy Blvd., Suite 1800, Philadelphia, PA 19103-2899. Customer Service Office: Elsevier Health Sciences Division, Subscription Customer Service, 3251 Riverport Lane, Maryland Heights, MO 63043. Periodicals postage paid at New York, NY, and additional mailing offices. (Source: Air Medical Journal)

Editorial Board

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Jacqueline C. Stocking, RN, MSN, MBA, CMTE, CEN, CFRN, FP-C, CCP-C, NREMT-P, Corresponding Editor University of California Davis Medical Center (Source: Air Medical Journal)

Air Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Air Medical Journal)

Severity of Cardiovascular Disease Patients Transported by Air Ambulance

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Conclusion: Disease was more clinically severe and the outcome was poorer among patients with cardiovascular diseases transported by HEMS than by other means. (Source: Air Medical Journal)

Australian Dust Storm: Impact on a Statewide Air Medical Retrieval Service

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Conclusion: An increased demand on retrieval services was demonstrated during the period of the dust storm event. Despite grounding of the air medical fleet, all cases except one were able to be retrieved within clinically appropriate time frames or by alternative transport methods. Contingency plans need to be developed to cope with the possibility of similar events in the future, to prevent adverse events from occurring. (Source: Air Medical Journal)

Influence of Helicopter Flight on Temperature of Helicopter EMS Crewmembers

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Conclusion: Among healthy subjects, the helicopter vibrations may induce an increase in body temperature. Small sample size and lack of information on a number of potential confounders prevented the identification of the possible determinants of a temperature decrease among some subjects. (Source: Air Medical Journal)

Air Medical Evacuations from a Developing World Conflict Zone

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations–backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda–backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian p...

2011 Critical Care Transport Workplace and Salary Survey

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Abstract: Critical care transport (CCT) leaders from 260 organizations were invited to participate in an online, hosted survey of industry compensation and workplace practices. Approximately 150 questions were presented to participants, soliciting a broad base of information on CCT organizations, personnel, compensation, and workplace practices, notably alertness and fatigue management. CCT organizational salaries are represented by common job class and reported by summary with minimum, middle, and maximum hourly rates in a national aggregate and by Association of Air Medical Services region. (Source: Air Medical Journal)

Forum

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

This summer the National Transportation and Safety Board (NTSB) released its “Top-10 Most Wanted,” and at the top of their list is “pilot and air traffic controller professionalism.” The following is an excerpt from one of the statements posted by the NTSB on their website: “Although the vast majority of the pilots and air traffic controllers responsible for millions of flights each year routinely perform as qualified and competent professionals under a variety of demanding circumstances, there have been a disturbing number of individual incidents of noncompliant behavior, intentional misconduct, or lack of commitment to essential task. These occurrences demonstrate an erosion of pilot and air traffic controller professionalism.” (Source: Air Medical Journal)

Concern Network

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

An EagleMed (Wichita, KS) crew was responding when their AS 350B2 departed the helipad vertically. At approximately 25 feet, the aircraft lost power. Pilot reduced collective and returned to the helipad. The aircraft was taken out of service for inspection. The cause of power loss was under investigation, and the base continued service with a spare helicopter. The weather was clear and not a factor. (Source: Air Medical Journal)

HEMS and Trauma Patients

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Granville-Chapman J, Jacobs N, Midwinter MJ. Pre-hospital haemostatic dressings: a systematic review. Injury 2011;42:447-59. Uncontrollable hemorrhage is a difficult problem for emergency medical services (EMS). As the authors note, it is the second leading cause of death from civilian trauma. The experience in southwest Asia has accelerated development of hemostatic dressings, because significant delay of evacuation may occur under battle conditions. The dressings have continued to steadily improve as far as increased efficacy and decreased worrisome side effects. (Source: Air Medical Journal)

Mother's Little Helper: The Problem of Narcotic Diversion

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

The neonatal intensive care unit is bustling at 7:30 am. A popular neonatologist is late for his shift. So is his girlfriend, who is a nurse in the unit. Pages and phone calls go unanswered. Police are sent to the address for a wellness check. Both the physician and the nurse are found dead of an overdose of fentanyl. Recent narcotic discrepancies had been explained away, but an investigation revealed that, over a period of months, the neonatologist would prescribe a fentanyl drip and the nurse would prepare it, but before it could be administered, the physician would cancel it, the nurse would document the “waste,” and they would take it home for recreational use, subsequently resulting in both of their deaths. (Source: Air Medical Journal)

Certification Review

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Which of the following symptoms would the transport team expect to see in a patient with increased intracranial pressure? (Source: Air Medical Journal)

Helicopter Scene Response for a STEMI Patient Transported Directly to the Cardiac Catheterization Laboratory

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

At 2:10 pm, a 40-year-old Caucasian woman with no known medical history called 911 complaining of substernal, crushing chest pain that had started 2 to 3 hours before she called emergency medical services (EMS). EMS arrived at 2:24 pm and obtained a 12-lead electrocardiogram (ECG) diagnostic of ST-segment elevation myocardial infarction (STEMI) at 2:36 pm. University Air Care was requested by local EMS at 2:42 pm to respond directly to the cardiac scene in rural Ohio for rapid transport to a facility capable of performing percutaneous coronary intervention (PCI). The closest PCI-capable facility was approximately 35 minutes away by ground or 13 minutes by air. The closest non-PCI hospital was approximately 20 minutes away by ground (). (Source: Air Medical Journal)

Creating Standards

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Standards are the basis for every accreditation agency, and the Commission on Accreditation of Medical Transport Systems (CAMTS) is no different. We began working on the 9th edition as soon as the 8th edition Accreditation Standards were published in September 2010, because creating standards is a dynamic process, reflecting the evolution of the medical transport profession. In the 9th edition, we will be creating standards for two new areas: international fixed-wing programs and levels of critical care. (Source: Air Medical Journal)

Letters to the Editors

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Dear Editors: I would like to address the article in the November/December 2010 issue on pages 300–303, titled “HEMS Simulator Training for Safety and Clinical Proficiency.” As the author mentions at the start of his article, “In December 2006, a Bell 412SP EMS helicopter was destroyed, and the pilot and 2 medical crewmembers on board perished.” That helicopter was carrying three professional operators who also happened to be my coworkers and personal friends. (Source: Air Medical Journal)

General Information

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Air Medical Journal (ISSN 1067-991X) is published bimonthly by Elsevier Inc., 360 Park Avenue South, New York, NY 10010-1710. Months of issue are January, March, May, July, September, and November. Business and Editorial Offices: 1600 John F. Kennedy Blvd., Suite 1800, Philadelphia, PA 19103-2899. Customer Service Office: Elsevier Health Sciences Division, Subscription Customer Service, 3251 Riverport Lane, Maryland Heights, MO 63043. Periodicals postage paid at New York, NY, and additional mailing offices. (Source: Air Medical Journal)

Editorial Board

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

Jacqueline C. Stocking, RN, MSN, MBA, CMTE, CEN, CFRN, FP-C, CCP-C, NREMT-P, Corresponding Editor, University of California Davis Medical Center, Roseville, CA (916) 865-6008 (Source: Air Medical Journal)

Air Medical Journal — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Air Medical Journal)

St. Louis Children's Hospital Critical Care Transport Team