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Ayuningtyas D, Oktarina R, Pebrina A, Sakka A, Rozali R, Barinda S, Pramesti A. Indonesian air medical evacuation: Analyzing readiness and proposing an integrated standard procedure. J Public Health Res 2024; 13:22799036241237947. [PMID: 38577244 PMCID: PMC10989052 DOI: 10.1177/22799036241237947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
Indonesia still faces challenges in providing healthcare services, and it is crucial to develop an air medical evacuation services system for at least two reasons. Firstly, Indonesia is an archipelagic country and a popular tourist destination. Secondly, there are still significant disparities in the number and types of healthcare facilities and health workers nationwide. To respond to the current situation, the healthcare providers and government have made some efforts regarding air medical evacuation but are showing an unintegrated system. This qualitative study aimed to explore the current implementation of air medical evacuation in Indonesia and to propose an integrated standard procedure that all related stakeholders can adopt at the national and regional levels. The study used a multi-case design analysis, collecting both primary and secondary data. Secondary data was gathered through desk studies to learn related policies and previous studies. Primary data was collected through observation and in-depth interviews with relevant stakeholders, including regulators, service providers, practitioners, and non-governmental organizations. The study found that there is currently a regulatory gap for the implementation of air medical evacuation services in Indonesia. The readiness of the Health Human Resources (HHR) is limited in terms of qualification and competency, and the definitive infrastructure of air medical evacuation requires improvement since the providers continue to use the airport for civil transportation. Besides, the interaction pattern between stakeholders needs to be integrated into standardized procedures. Therefore, the study recommends proposing an integrated standard procedure and actionable recommendations to advocate for all stakeholders.
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Affiliation(s)
- Dumilah Ayuningtyas
- Health Policy and Administration Department, Faculty of Public Health, Universitas Indonesia, Depok, Republic of Indonesia
| | - Ratih Oktarina
- Health Policy and Administration Department, Faculty of Public Health, Universitas Indonesia, Depok, Republic of Indonesia
| | - Anita Pebrina
- Health Policy and Administration Department, Faculty of Public Health, Universitas Indonesia, Depok, Republic of Indonesia
| | - Ambo Sakka
- Faculty of Public Health, Universitas Halu Oleo Kendari, Sulawesi, Republic of Indonesia
| | - Roni Rozali
- Ministry of Health, Jakarta, Republic of Indonesia
| | - Sandra Barinda
- National Agency of Drug and Food Control, Jakarta, Republic of Indonesia
| | - Alya Pramesti
- Health Policy and Administration Department, Faculty of Public Health, Universitas Indonesia, Depok, Republic of Indonesia
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Martinez T, Simon K, Lely L, Nguyen Dac C, Lefevre M, Aloird P, Leschiera J, Strehaiano S, Nespoulous O, Boutonnet M, Raynaud L. Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study. BMJ Mil Health 2023; 169:443-447. [PMID: 34244377 DOI: 10.1136/bmjmilitary-2021-001876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022]
Abstract
After the appearance of the COVID-19 pandemic in France, MEROPE system was created to transform the military tactical ATLAS A400M aircraft into a flying intensive care unit. Collective aeromedical evacuations (aero-MEDEVAC) of patients suffering from SARS-CoV-2-related acute respiratory distress syndrome was performed from June to December 2020. A total of 22 patients were transported during seven missions. All aero-MEDEVAC was performed in safe conditions for patients and crew. No life-threatening conditions occurred during flight. Biohazard controls were applied according to French guidelines and prevented crew contamination. Thanks to rigorous selection criteria and continuous in-flight medical care, the safe transportation of these patients was possible. To the best of our knowledge, this is the first description of collective aero-MEDEVAC of these kinds of patients using a tactical military aircraft. We here describe the patient's characteristics and the flight's challenges.
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Affiliation(s)
- Thibault Martinez
- Federation of Anesthesiology, Intensive Care Unit, Burns and Operating Theater, Percy Military Training Hospital, Clamart, France
| | - K Simon
- 160th Military Medical Unit, Istres, France
| | - L Lely
- 190th Military Medical Unit, Lanester, France
- French Military Health Service, Paris, France
| | | | - M Lefevre
- 100th Military Medical Unit, Bricy, France
| | - P Aloird
- 100th Military Medical Unit, Bricy, France
| | - J Leschiera
- 50th Military Medical Unit, TOUL CEDEX, France
| | | | - O Nespoulous
- Aeromedical Research Expertise Training Department, French Armed Forces Biomedical Research Institute, Bretigny sur Orge, France, France
| | - M Boutonnet
- Federation of Anesthesiology, Intensive Care Unit, Burns and Operating Theater, Percy Military Training Hospital, Clamart, France
| | - L Raynaud
- Federation of anesthesiology, intensive care unit, Military Training Hospital Begin, Saint Mande, Île-de-France, France
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Stucchi R, Ripoll-Gallardo A, Sechi GM, Weinstein ES, Villa GF, Frigerio C, Federighi F, Grasselli G, Zoli A, Bonora R, Fumagalli R. Severe Acute Respiratory Syndrome Coronavirus 2 and Medical Evacuation in Lombardy: Lessons Learned from an Unprecedented Pandemic. Disaster Med Public Health Prep 2023; 17:e480. [PMID: 37667885 DOI: 10.1017/dmp.2023.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerging infectious disease pandemic developed in Lombardy (northern Italy) during the last week of February 2020 with a progressive increase of patients presenting with serious clinical findings. Despite the efforts of the Central Italian Government, regional resources were rapidly at capacity. The solution was to plan the medical evacuation (MEDEVAC) of 119 critically ill patients (median age 61 years) to in-patient intensive care units in other Italian regions (77) and Germany (42). Once surviving patients were deemed suitable, the repatriation process concluded the assignment. The aim of this report is to underline the importance of a rapid organization and coordination process between different nodes of an effective national and international network during an emerging infectious disease outbreak and draw lessons learned from similar published reports.
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Affiliation(s)
- Riccardo Stucchi
- SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alba Ripoll-Gallardo
- SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | | | - Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | | | - Cristina Frigerio
- Dipartimento di Anestesia e Rianimazione, ASST Melegnano Martesana, Cernusco sul Naviglio, Italy
| | | | - Giacomo Grasselli
- Department of Anesthesia and Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Alberto Zoli
- Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
| | - Rodolfo Bonora
- Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
| | - Roberto Fumagalli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Herstein JJ, Figi CE, Le AB, Beam EL, Lawler JV, Schnaubelt ER, Carter GW, Lowe JJ, Gibbs SG. An Updated Review of Literature for Air Medical Evacuation High-Level Containment Transport During the Coronavirus Disease 2019 Pandemic. Air Med J 2023; 42:201-209. [PMID: 37150575 PMCID: PMC9808413 DOI: 10.1016/j.amj.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/27/2022] [Indexed: 05/09/2023]
Abstract
OBJECTIVE In 2019, our team conducted a literature review of air medical evacuation high-level containment transport (AE-HLCT) of patients infected with high-consequence pathogens. Since that publication, the coronavirus disease 2019 (COVID-19) pandemic has resulted in numerous air medical evacuations. We re-examined the new literature associated with AE-HLCTs to determine new innovations developed as a result of the pandemic. METHODS A literature search was performed in PubMed/MEDLINE from February 2019 to October 2021. The authors screened abstracts for the inclusion criteria and reviewed full articles if the abstract was relevant to the aim. RESULTS Our search criteria yielded 19 publications. Many of the early transports of patients with COVID-19 used established protocols for AE-HLCT, which were built from the most recent transports of patients with Ebola virus disease. Innovations from the identified articles are subdivided into preflight considerations, in-flight operations, and postflight operations. CONCLUSION Lessons gleaned from AE-HLCTs of patients with COVID-19 in the early weeks of the pandemic, when little was known about transmission or the severity of the novel disease, have advanced the field of AE-HLCT. Teams that had never conducted such transports now have experience and processes. However, more research into AE-HLCT is needed, including research related to single-patient portable isolation units as well as containerized/multipatient transportation systems.
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Affiliation(s)
- Jocelyn J Herstein
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE.
| | - Claire E Figi
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX
| | - Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Elizabeth L Beam
- Global Center for Health Security, Omaha, NE; College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - James V Lawler
- Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE
| | - Elizabeth R Schnaubelt
- Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE; United States Air Force School of Aerospace Medicine, Dayton, OH
| | | | - John J Lowe
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX
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Ohsaka H, Nagasawa H, Ota S, Muramatsu KI, Jitsuiki K, Ishikawa K, Yanagawa Y. Analysis of the Activities of a Physician-Staffed Helicopter in the Coronavirus Disease 2019 Pandemic Phase. Air Med J 2022; 41:376-379. [PMID: 35750444 PMCID: PMC9119741 DOI: 10.1016/j.amj.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 12/04/2022]
Abstract
Objective The purpose of this study was to investigate changes in the duration of activity of a physician-staffed helicopter emergency medical service (HEMS) in Eastern Shizuoka Prefecture before and during the coronavirus disease 2019 pandemic. Methods We retrospectively investigated the duration of dispatch activities from February 2020 to June 2021 (pandemic group, n = 1,032) and from April 2016 to January 2020 (control group, n = 3,054). Results There were no significant differences in the average age, percentage of male patients, interval from the request of HEMS dispatch to arrival, interval from arrival at the scene to leaving the scene, interval from leaving the scene to arrival at the hospital, or the ratio of requests for HEMS dispatch from the local fire department between the control and pandemic groups. In contrast, the interval from the first call to HEMS dispatch in the control group was significantly shorter than that in the pandemic group, and the ratio of requests for HEMS dispatch before contacting patients in the control group was significantly greater than that in the pandemic group. Conclusion The interval from the first call to HEMS dispatch was prolonged in the COVID-19 pandemic period. However, the actual activity time of the HEMS was not affected.
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Aeromedical Transportation of the Critically Ill Cardiac Patient: Pre-flight Planning and Preparation. Curr Probl Cardiol 2022:101246. [DOI: 10.1016/j.cpcardiol.2022.101246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
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Haghpanah F, Ghobadi K, Schafer BW. Multi-hazard hospital evacuation planning during disease outbreaks using agent-based modeling. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 66:102632. [PMID: 34660188 PMCID: PMC8507583 DOI: 10.1016/j.ijdrr.2021.102632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/26/2021] [Accepted: 10/10/2021] [Indexed: 05/06/2023]
Abstract
As different types of hazards, including natural and man-made, can occur simultaneously, to implement an integrated and holistic risk management, a multi-hazard perspective on disaster risk management, including preparedness and planning, must be taken for a safer and more resilient society. Considering the emerging challenges that the COVID-19 pandemic has been introducing to regular hospital operations, there is a need to adapt emergency plans with the changing conditions, as well. Evacuation of patients with different mobility disabilities is a complicated process that needs planning, training, and efficient decision-making. These protocols need to be revisited for multi-hazard scenarios such as an ongoing disease outbreak during which additional infection control protocols might be in place to prevent transmission. Computational models can provide insights on optimal emergency evacuation strategies, such as the location of isolation units or alternative evacuation prioritization strategies. This study introduces a non-ICU patient classification framework developed based on available patient mobility data. An agent-based model was developed to simulate the evacuation of the emergency department at the Johns Hopkins Hospital during the COVID-19 pandemic due to a fire emergency. The results show a larger nursing team can reduce the median and upper bound of the 95% confidence interval of the evacuation time by 36% and 33%, respectively. A dedicated exit door for COVID-19 patients is relatively less effective in reducing the median time, while it can reduce the upper bound by more than 50%.
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Affiliation(s)
- Fardad Haghpanah
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Kimia Ghobadi
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, USA
| | - Benjamin W Schafer
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD, USA
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James D, Talbot LA. Neonatal Aeromedical Evacuation During COVID-19: An Interview With Captain Danielle James. Mil Med 2021; 186:74-80. [PMID: 34469524 PMCID: PMC8499835 DOI: 10.1093/milmed/usab250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/03/2022] Open
Abstract
During the coronavirus-19 pandemic, limited information existed about the risks and consequences of severe acute respiratory syndrome coronavirus 2 infection associated with maternal transmission to neonates. With rapidly evolving evidence, Air Force Neonatal Intensive Care Unit nurses at U.S. Naval Hospital Okinawa, Japan, adapted their standard operating procedures to safeguard their at-risk neonatal patients. This interview describes an Air Force NICU nurse's view of neonatal transport and nursing care during the coronavirus-19 pandemic.
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Affiliation(s)
- Danielle James
- 18th Healthcare Operations Squadron, Kadena AB, Okinawa 96368, Japan
| | - Laura A Talbot
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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Berry CL, Corsetti MC, Mencl F. Helicopter Emergency Medical Services Transport of COVID-19 Patients in the "First Wave": A National Survey. Cureus 2021; 13:e16961. [PMID: 34373827 PMCID: PMC8346337 DOI: 10.7759/cureus.16961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
Study objectives Helicopter emergency medical services (HEMS) providers have had to adjust to transporting patients with a novel, highly infectious pathogen. This study describes how HEMS organizations in the USA approached the coronavirus disease 2019 (COVID-19) pandemic in its first wave. Methods A survey was distributed via REDCap™ to HEMS organizations in May of 2020 using a national database. Data were collected regarding agency demographics and COVID-19 practices, including education, risk assessment, protective measures, equipment use, and decontamination practices. These were analyzed for qualitative observations and program attributes for COVID transport. Results A total of 68/287 (24%) organizations responded and completed the survey. Eighty-five percent (85%) of responding programs reported that they chose to transport known or suspected COVID-19 patients by air medical transport. Of responding programs, 93% provided education to their providers regarding COVID-19 and 100% conducted a COVID-19 risk analysis for patient transports. Of agencies transporting known or suspected COVID-19 patients, 77% required the use of N95 filtering facepiece respirators (N95) or powered air-purifying respirators (PAPR) for crewmembers during known or suspected COVID-19 patient transfers and 95% provided N95 respirators for pilots during transport. Five percent of responding programs utilized portable negative pressure isolation units. For COVID-19 transporting and non-transporting agencies, when transporting non-COVID-19 known or suspected patients, personal protective equipment (PPE) practice varied but tended to be more relaxed. Some services separated pilots from providers even during downtime (29%). Among services transporting known or suspected COVID-19 patients, the most common decontamination practice was manual wipe-down of all surfaces for a downtime of less than two hours. Conclusion The majority of survey respondents report that their programs chose to transport patients with known or suspected COVID-19 by air medical transport. However, there was high variability in practices regarding the transport of known or suspected COVID-19 as well as that of non-COVID-19 known or suspected patients by air during the initial outbreak of the pandemic. The HEMS industry may benefit from further research and standardization of airborne highly infectious disease transport practices in preparation for the next respiratory virus pandemic.
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Affiliation(s)
- Christopher L Berry
- Department of Emergency Medicine, Guthrie Robert Packer Hospital, Sayre, USA
| | - Monica C Corsetti
- Department of Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Francis Mencl
- Department of Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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Alami H, Lehoux P, Fleet R, Fortin JP, Liu J, Attieh R, Cadeddu SBM, Abdoulaye Samri M, Savoldelli M, Ag Ahmed MA. How Can Health Systems Better Prepare for the Next Pandemic? Lessons Learned From the Management of COVID-19 in Quebec (Canada). Front Public Health 2021; 9:671833. [PMID: 34222176 PMCID: PMC8249772 DOI: 10.3389/fpubh.2021.671833] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022] Open
Abstract
The magnitude of the COVID-19 pandemic challenged societies around our globalized world. To contain the spread of the virus, unprecedented and drastic measures and policies were put in place by governments to manage an exceptional health care situation while maintaining other essential services. The responses of many governments showed a lack of preparedness to face this systemic and global health crisis. Drawing on field observations and available data on the first wave of the pandemic (mid-March to mid-May 2020) in Quebec (Canada), this article reviewed and discussed the successes and failures that characterized the management of COVID-19 in this province. Using the framework of Palagyi et al. on system preparedness toward emerging infectious diseases, we described and analyzed in a chronologically and narratively way: (1) how surveillance was structured; (2) how workforce issues were managed; (3) what infrastructures and medical supplies were made available; (4) what communication mechanisms were put in place; (5) what form of governance emerged; and (6) whether trust was established and maintained throughout the crisis. Our findings and observations stress that resilience and ability to adequately respond to a systemic and global crisis depend upon preexisting system-level characteristics and capacities at both the provincial and federal governance levels. By providing recommendations for policy and practice from a learning health system perspective, this paper contributes to the groundwork required for interdisciplinary research and genuine policy discussions to help health systems better prepare for future pandemics.
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Affiliation(s)
- Hassane Alami
- Center for Public Health Research of the University of Montreal, Montreal, QC, Canada
- Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada
| | - Pascale Lehoux
- Center for Public Health Research of the University of Montreal, Montreal, QC, Canada
- Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada
| | - Richard Fleet
- VITAM Research Centre on Sustainable Health, Laval University, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
- Research Chair in Emergency Medicine Université Laval-CHAU Hôtel-Dieu de Lévis, Lévis, QC, Canada
| | - Jean-Paul Fortin
- VITAM Research Centre on Sustainable Health, Laval University, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Joanne Liu
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Randa Attieh
- Research Centre of the University of Montreal Hospital Centre, University of Montreal, Montreal, QC, Canada
| | - Stéphanie Bernadette Mafalda Cadeddu
- Research Centre of the University of Montreal Hospital Centre, University of Montreal, Montreal, QC, Canada
- Faculty of Law, University of Montreal, Montreal, QC, Canada
| | | | | | - Mohamed Ali Ag Ahmed
- Research Chair on Chronic Diseases in Primary Care, Sherbrooke University, Chicoutimi, QC, Canada
- The Institute of Tropical Medicine, Antwerp, Belgium
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Sammito S, Turc J, Post J, Beaussac M, Hossfeld B, Boutonnet M. Analysis of European Air Medical Evacuation Flights of Coronavirus Disease 2019 Patients. Air Med J 2021; 40:211-215. [PMID: 34172226 PMCID: PMC8020095 DOI: 10.1016/j.amj.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 01/06/2023]
Abstract
Objective As part of the humanitarian response to the coronavirus disease 2019 (COVID-19) pandemic, the German and French Armed Forces provided air transport for patients from overwhelmed regional hospitals in Italy and France. The objective of this study was to analyze the characteristics of the missions and the medical conditions of COVID-19 patients transported during an air medical evacuation on fixed wing aircraft in March and April 2020. Method This was a retrospective analysis of transport records as well as other documents for 58 COVID-19 patients requiring artificial ventilation. Results The median age of the transported patients was 61.5 years, and 61% of them had preexisting medical conditions. They had been ventilated for a median of 5 days and experienced the first symptoms 18 days before transport. The patients flown out of France had less days of ventilation before flight, a lower end-tidal carbon dioxide level at the beginning of the flight, and a lower Charlson Comorbidity Index. There were also some differences between the ventilation and the flight level flown by the 2 air forces. Conclusion The intensive care transport of ventilated COVID-19 patients requires highly qualified personnel and appropriate equipment and should be planned appropriately.
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Affiliation(s)
- Stefan Sammito
- Department of Research, Science and Testing, German Air Force Centre for Aerospace Medicine, Cologne, Germany; Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.
| | - Jean Turc
- Intensive Care Unit Anaesthesiology Department, Military Teaching Hospital Desgenettes, Lyon, France
| | - Janina Post
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, Magdeburg, Germany; Special Air Mission Wing Federal Ministry of Defence, Cologne, Germany
| | | | - Björn Hossfeld
- Department X - Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Hospital Ulm, Ulm, Germany
| | - Mathieu Boutonnet
- Intensive Care Unit Anaesthesiology Department, Military Teaching Hospital Percy, Clamart, France; Military Medical Academy, Val-de-Grâce, Paris, France
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