Air Medical Journal

2012-05-01

Editorial Board

2012-05-01

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

General Information

2012-05-01

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.

Transition Plans

Eileen Frazer — 2012-05-01

In aviation, the Federal Aviation Administration requires that a Part 135 Certificate Holder must have a transition plan for key positions and tasks. The purpose of this plan is to ensure operations and safety are not negatively impacted when anticipated and unanticipated changes occur.

Intractable Seizures in a 4-Month-Old Girl

Peter Tilney, Samuel Schaab, Heather Cady — 2012-05-01

A 4-month-old, 7-kg girl with a 3-day history of mild diarrhea was brought into a rural emergency department (ED) by private vehicle. The patient's parents reported that the child was in her usual state of health until the past several days, when she began having multiple loose stools. After an extensive interview, the family said she was born full term without any complications. She had never been hospitalized and was up to date on all of her immunizations. Family also stated emphatically that there was no alteration in her formula concentration and intake before her presentation. Approximately 30 minutes before her arrival, her parents noticed “shaking of the extremities” consistent with seizure activity. Concurrently, they noted she had irregular respirations and was not acting at her baseline.

When Is a Calendar a Kickback?

John R. Clark — 2012-05-01

The debate over the future of health care spending is at its peak with the presidential election on the horizon, but the ideas of fiscal responsibility and fair distribution of the federal health care dollar have always been present. Although many seasoned readers may know all of the ins and outs of the anti-kickback statute, in the competitive environment that many programs find themselves in today, in which we are trying to find creative ways of financing operations and expanding our markets, it is always good to revisit some of the classics.

Field Trauma Triage Guide Revised

Daniel Hankins — 2012-05-01

Sasser SM, Hunt RC, Faul M, Sugerman D, Pearson WS, Dulski T, et al. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. Morb Mort Weekly Report (MMWR) 2012;61(No RR-1).

Forum

2012-05-01

This spring, ASTNA sponsored both our president and president elect to attend the AAMS Spring Legislative Conference in Washington, DC. Pertinent legislation was discussed, but the most impact that we had was hitting the Hill in our flight suits. It was amazing how many doors were opened to us, in both the offices of the Representatives of the House and the Senate. We were able to meet with the health care advisors for several offices.

Simulator Training: Reducing Risk in Helicopter Rescue

2012-05-01

In most countries, preclinical emergency medicine is exclusively run by paramedics. In Germany, Prof. Martin Kirschner, as one of the leading surgeons of his time, proposed as early as 1938 to bring the doctor to the patient and not the other way around. According to Kirschner, inappropriate treatment on scene and improper transport to the hospital have the potential to cause even more damage to the injured person than the injury itself. Based on this theory, Germany's preclinical emergency medicine developed and is now, because of this history, performed by a physician-staffed system, for rescue missions by both land and air transport whenever indicated.

Collective Air Medical Evacuation: The French Tool

Marc Borne, Jean P. Tourtier, Solange Ramsang, Laurent Grasser, Bruno Pats — 2012-05-01

The cornerstone of the current concept of military medical operations is the function, fit, and form of the provision of en route care. The life-saving capability of far-forward surgery creates the need for a new and unique ability: to move stabilized, but not necessarily stable, patients. The current system of en route care serves as a primary and indispensable portion of the continuum of critical care. Without the capability of moving patients, the ability to do far forward surgery would be meaningless.

Unknown, Unrecognized, and Underreported: Flicker Vertigo in Helicopter Emergency Medical Services

Kevin High, Amy Moore — 2012-05-01

A newly hired flight nurse began her first day on duty, embarking on a new career path and exposure to an entirely different work environment. She is part of a rotor wing transport team; on her second transport of the day the pilot in command places her in the left front seat of the American Eurocopter EC-145. The weather is sunny, clear with unlimited visibility. Shortly after lift, she began experiencing nausea. It began slowly; she looked at the horizon as she was taught in preflight orientation, but without relief. The nausea went unabated and later proceeded to several episodes of vomiting. Following this, she felt exhausted.

Heliox in Children with Croup: A Strategy to Hasten Improvement

2012-05-01

Abstract: Objective: Upper airway obstruction is responsive to the reduction in airflow turbulence provided by helium/oxygen (heliox) admixture. Our pediatric critical care transport team (PCCTT) has used heliox for children with upper airway obstruction from croup. We sought to describe our experience with heliox on transport and hypothesized that heliox-treated children with croup would show a more rapid clinical improvement. Methods: Children with croup transported by our PCCTT and admitted to the PICU were evaluated. We analyzed pretransport care, transport interventions, and outcomes. Croup scores (Modified Taussig) were assigned retrospectively according to respiratory therapy charting. Data were analyzed using appropriate statistical tests, including Pearson's chi-square test, Fisher's exact test, Mann-Whitney U rank comparison, and two-sample t-test. Results: Thirty-five children met inclusion criteria. Demographics were similar between groups. The pretransport medical care was similar between groups. Children receiving heliox had a higher baseline croup score [mean (SD) = 5.7(2.3) vs no heliox 2.9 (2.0), P < 0.001]. The improvement in croup scores over the first 60 minutes of transport was more rapid in the heliox-treated children (P < 0.001). There was no difference in the number of children requiring additional nebulized racemic epinephrine during transport. The PICU length of stay (P = 0.59) and hospital length of stay (P = 0.64) were similar between groups. Conclusion: Heliox added to standard transport treatment for critically ill children with croup provides a more rapid improvement in croup scores. Heliox for croup during transport does not prolong intensive care unit stay. A prospective clinical trial is warranted to evaluate heliox in pediatric transport.

Air Medical Services Must Be Prepared for Massive Transfusion

Luke D. Lawton — 2012-05-01

In 1928, the first Australian civilian air medical service was established in Cloncurry, Queensland. Today, air medical transport of patients in Queensland—a state incorporating a land area of 1.7 million square kilometers and a decentralized population of 4.4 million people—presents significant challenges to the field of retrieval medicine.

I'll Take Passion for $1000

Janie Kofford Ford — 2012-05-01

Recently a health care institution implemented a new uniform policy based on input from patient surveys. It had been determined that patients perceived nurses in white uniforms as more professional, so the nurses now wear white tops in most areas of the hospital, including the emergency department. Often hospital lobbies more closely resemble a luxury hotel. Nametags are getting longer and longer as more certifications and degrees become the norm, hospital rooms more closely resemble more casual and less aseptic settings; yet when I evaluate the success or failure of a patient interaction, I never consider the uniform, certifications, or ambiance. Rather, I think I am like most patients in that our judgment is based on the way we feel.

Concern Network

2012-05-01

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.

Certification Review

Jill Johnson — 2012-05-01

In a survival situation, how many liters of water should a person consume in temperate conditions to stay hydrated?

Air Medical Journal

Table of Contents

Editorial Board

General Information

Transition Plans

Intractable Seizures in a 4-Month-Old Girl

When Is a Calendar a Kickback?

Field Trauma Triage Guide Revised

Forum

Simulator Training: Reducing Risk in Helicopter Rescue

Collective Air Medical Evacuation: The French Tool

Unknown, Unrecognized, and Underreported: Flicker Vertigo in Helicopter Emergency Medical Services

Heliox in Children with Croup: A Strategy to Hasten Improvement

Air Medical Services Must Be Prepared for Massive Transfusion

I'll Take Passion for $1000

Concern Network

Certification Review