Helicopter transport of patients to tertiary care centers after cardiac arrest

Werman, Howard A.; Falcone, Robert A; Shaner, Steven; Herron, Holly; Lacey, P A; Childress, Susan; Kampman, Gwen

doi:10.1016/s0735-6757(99)90043-8

Cited by 28 publications

(11 citation statements)

References 24 publications

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“…16 Another study suggested that the etiology of the cardiac arrest should be considered before making a decision regarding transport. 17 Patients who suffered a primary cardiac arrest had favorable outcomes when transported by air, whereas patients who experienced a cardiac arrest as a result of a noncardiac medical illness showed no increased benefits when transported via air. 17 Despite these conflicting results, cardiac arrest patients continue to be transported via air.…”

Section: Discussionmentioning

confidence: 99%

“…17 Patients who suffered a primary cardiac arrest had favorable outcomes when transported by air, whereas patients who experienced a cardiac arrest as a result of a noncardiac medical illness showed no increased benefits when transported via air. 17 Despite these conflicting results, cardiac arrest patients continue to be transported via air. However, more research is needed to determine whether or not such flights offer any benefit to the patients and what effect patient location has on outcomes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of Nontrauma Scene Flights for Air Medical Transport

Krebs

Fletcher

Werman

et al. 2014

Air Medical Journal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characteristics of Nontrauma Scene Flights for Air Medical Transport

Krebs

Fletcher

Werman

et al. 2014

Air Medical Journal

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“…HEMS transport of post-ROSC OHCA patients has previously been suggested to improve outcome [10] but this is likely to be dependent on the aetiology of cardiac arrest, geography and transport times involved. In the paper published by Werman et al, a significant number of patients had non-cardiac cause of OHCA compared to our study.…”

Section: Discussionmentioning

confidence: 99%

Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest

Lyon

Nelson

2013

Scand J Trauma Resusc Emerg Med

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BackgroundOut-of-hospital cardiac arrest (OHCA) is a common medical emergency with significant mortality and significant neurological morbidity. Helicopter emergency medical services (HEMS) may be tasked to OHCA. We sought to assess the impact of tasking a HEMS service to OHCA and characterise the nature of these calls.MethodRetrospective case review of all HEMS calls to Surrey and Sussex Air Ambulance, United Kingdom, over a 1-year period (1/9/2010-1/9/2011). All missions to cases of suspected OHCA, of presumed medical origin, were reviewed systematically.ResultsHEMS was activated 89 times to suspected OHCA. This represented 11% of the total HEMS missions. In 23 cases HEMS was stood-down en-route and in 2 cases the patient had not suffered an OHCA on arrival of HEMS. 25 patients achieved return-of-spontaneous circulation (ROSC), 13 (52%) prior to HEMS arrival. The HEMS team were never first on-scene. The median time from first collapse to HEMS arrival was 31 minutes (IQR 22–40). The median time from HEMS activation to arrival on scene was 17 minutes (IQR 11.5-21). 19 patients underwent pre-hospital anaesthesia, 5 patients had electrical or chemical cardioversion and 19 patients had therapeutic hypothermia initiated by HEMS. Only 1 post-OHCA patient was transported to hospital by air. The survival to discharge rate was 6.3%.ConclusionOHCA represents a significant proportion of HEMS call outs. HEMS most commonly attend post-ROSC OHCA patients and interventions, including pre-hospital anaesthesia and therapeutic hypothermia should be targeted to this phase. HEMS are rarely first on-scene and should only be tasked as a first response to OHCA in remote locations. HEMS may be most appropriately utilised in OHCA by only attending the scene if a patient achieves ROSC.

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“…Prehospital providers may consider direct transport of these patients to facilities with expertise in neurocritical care [38]. Otherwise, transfer of drowning victims who are stabilized at the initial facility to a facility with neuroresuscitation expertise is recommended.…”

Section: Prehospital Managementmentioning

confidence: 99%

Brain Resuscitation in the Drowning Victim

et al. 2012

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Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide recommendations for management and investigation of the drowning victim. Epidemiology, brain-oriented prehospital and intensive care, therapeutic hypothermia, neuroimaging/monitoring, biomarkers, and neuroresuscitative pharmacology are addressed. When cardiac arrest is present, chest compressions with rescue breathing are recommended due to the asphyxial insult. In the comatose patient with restoration of spontaneous circulation, hypoxemia and hyperoxemia should be avoided, hyperthermia treated, and induced hypothermia (32–34 °C) considered. Arterial hypotension/hypertension should be recognized and treated. Prevent hypoglycemia and treat hyperglycemia. Treat clinical seizures and consider treating non-convulsive status epilepticus. Serial neurologic examinations should be provided. Brain imaging and serial biomarker measurement may aid prognostication. Continuous electroencephalography and N20 somatosensory evoked potential monitoring may be considered. Serial biomarker measurement (e.g., neuron specific enolase) may aid prognostication. There is insufficient evidence to recommend use of any specific brain-oriented neuroresuscitative pharmacologic therapy other than that required to restore and maintain normal physiology. Following initial stabilization, victims should be transferred to centers with expertise in age-specific post-resuscitation neurocritical care. Care should be documented, reviewed, and quality improvement assessment performed. Preclinical research should focus on models of asphyxial cardiac arrest. Clinical research should focus on improved cardiopulmonary resuscitation, re-oxygenation/reperfusion strategies, therapeutic hypothermia, neuroprotection, neurorehabilitation, and consideration of drowning in advances made in treatment of other central nervous system disorders.

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Helicopter transport of patients to tertiary care centers after cardiac arrest

Cited by 28 publications

References 24 publications

Characteristics of Nontrauma Scene Flights for Air Medical Transport

Characteristics of Nontrauma Scene Flights for Air Medical Transport

Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest

Brain Resuscitation in the Drowning Victim

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