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Weller M, Gibbs C, Pellatt R, MacKillop A. Use of continuous positive airway pressure and non-invasive ventilation for respiratory failure in an Australian aeromedical retrieval service: A retrospective case series. Emerg Med Australas 2021; 33:1001-1005. [PMID: 33855803 DOI: 10.1111/1742-6723.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/15/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the use of respiratory support via continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) in a medical retrieval service in Queensland, Australia, with reference to transport considerations and patient safety. METHODS In this unblinded retrospective case series over a 13-month period, a clinical database was reviewed for the use of CPAP/NIV. Retrieval metrics as well as clinical data were recorded. RESULTS A total of 128 patients were transferred either by rotary (80%) or fixed wing (20%). The median transport time was 65 min. The median total mission time was 3.7 h. Fifty-two percent of patients were female. The median age was 69 years and 93% had a background of cardiorespiratory disease. Sixty-five percent of patients were receiving CPAP/NIV before arrival of the retrieval team. The main diagnoses were respiratory failure (29.7%), acute pulmonary oedema (26.6%) and chronic obstructive pulmonary disease (25.8%). There were no incidences of pneumothorax, intubation in transit, vomiting, desaturation, hypotension, cardiac arrest or death. In two cases NIV was abandoned due to mask intolerance and in one case there was a decrease in Glasgow Coma Scale by 2. In no cases was there a detrimental outcome for the patient. CONCLUSION The use of NIV and CPAP appears to have a low-risk profile in aeromedical retrieval even for prolonged periods of time in an adult population.
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Affiliation(s)
- Martin Weller
- Department of Clinical Operations, LifeFlight Australia, Brisbane, Queensland, Australia
| | - Clinton Gibbs
- Office of the Clinical Director (Northern Operations), Retrieval Services Queensland, Townsville, Queensland, Australia
| | - Richard Pellatt
- Department of Clinical Operations, LifeFlight Australia, Brisbane, Queensland, Australia
| | - Allan MacKillop
- Department of Clinical Operations, LifeFlight Australia, Brisbane, Queensland, Australia
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Byun E, Kyoung K, Kim S, Keum M, Park S, Kim JT. The Efficiency of Ground Transport and Efficacy of Mobile Trauma Unit on the Inter-Hospital Transfer of Severe Trauma Patients. JOURNAL OF ACUTE CARE SURGERY 2019. [DOI: 10.17479/jacs.2019.9.1.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Eunae Byun
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyuhyouck Kyoung
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sungjeep Kim
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Minae Keum
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sungkyun Park
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jihoon T. Kim
- Department of Surgery, Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Goforth C, Bradley M, Pineda B, See S, Pasley J. Resuscitative Endovascular Balloon Occlusion of the Aorta: A Bridge to Flight Survival. Crit Care Nurse 2018; 38:69-75. [PMID: 29606678 DOI: 10.4037/ccn2018853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Trauma endures as the leading cause of death worldwide, and most deaths occur in the first 24 hours after initial injury as a result of hemorrhage. Historically, about 90% of battlefield deaths occur before the injured person arrives at a theater hospital, and most are due to noncompressible hemorrhage of the torso. Resuscitative endovascular balloon occlusion of the aorta is an evolving technique to quickly place a balloon into the thoracic or abdominal aorta to efficiently block blood flow to distal circulation. Maneuvers, such as resuscitative endovascular balloon occlusion of the aorta, to control endovascular hemorrhage offer a potential intervention to control noncompressible hemorrhage. This technique can be performed percutaneously or open in prehospital environments to restore hemodynamic functions and serve as a survival bridge until the patient is delivered to a treatment facility for definitive surgical hemostasis. This article describes the indications, complications, and application of resuscitative endovascular balloon occlusion of the aorta to military and civilian aeromedical transport.
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Affiliation(s)
- Carl Goforth
- CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland. .,CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland. .,MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC. .,Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland. .,Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course.
| | - Matthew Bradley
- CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.,CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland.,MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC.,Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland.,Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course
| | - Benilani Pineda
- CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.,CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland.,MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC.,Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland.,Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course
| | - Suzanne See
- CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.,CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland.,MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC.,Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland.,Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course
| | - Jason Pasley
- CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.,CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland.,MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC.,Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland.,Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course
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