Urgent air-medical transport: Right patient, place and time

Isakov, Alexander

doi:10.1503/cmaj.091258

Cited by 17 publications

(14 citation statements)

References 9 publications

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“…All persons dispatching a helicopter should be aware of the specific problems encountered in mountainous or wilderness areas. To make an informed decision on which is the most suitable asset(s) to deploy, the dispatcher should assess all available forms of patient access and transportation (Isakov, 2009;Rhodes et al, 1986;Tomazin, 2002). A computer-based Advanced Medical Priority Dispatch System (AMPDS) and a written checklist, specific to the area, covering available resources, protocols for activation of ground and air rescue units, as well as indications for activating HEMS may be a basis for the decision-making but should not exclude personal knowledge or experience (Ringburg, 2009).…”

Section: Dispatchingmentioning

confidence: 99%

“…The outcome of severely injured or ill patient, especially in hostile rural or mountain environment, is improved with rapid on-site medical treatment and transport to the nearest appropriate medical facility (Brugger et al, 2001;Elsensohn 2002;Falk et al, 1994;Haegeli et al, 2011;Isakov, 2009;Larsen et al, 1993). With optimal organization and modern helicopters, it is possible to have an activation time (time from emergency call to HEMS take off) of < 5 minutes.…”

Section: Timementioning

confidence: 99%

“…We believe that grievously ill and injured patients in remote or mountain areas are more endangered than their urban counterparts because of long response and evacuation times, bad weather, cold, dangerous terrain, inadequate equipment, and limited medical training of mountain rescuers. The outcome for an individual can potentially be dramatically improved by bringing rapid rescue and medical care to the accident scene, and by rapidly transporting the casualty to an appropriate medical facility (Isakov, 2009;Trunkey 1995). Two concepts, depending on victim's condition and other circumstances (weather, characteristics of terrain, evacuation times, etc.)…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medical Standards for Mountain Rescue Operations Using Helicopters: Official Consensus Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Tomazin

Ellerton

Reisten

et al. 2011

High Altitude Medicine & Biology

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The purpose of this article is to establish medical recommendations for safe and effective Helicopter Emergency Medical Systems (HEMS) in countries with a dedicated mountain rescue service. A nonsystematic search was undertaken and a consensus among members of International Commission for Mountain Emergency Medicine (ICAR Medcom) was reached. For the severely injured or ill patient, survival depends on approach time and quality of medical treatment by high-level providers. Helicopters can provide significant shortening of the times involved in mountain rescue. Safety is of utmost importance and everything possible should be done to minimize risk. Even in the mountainous environment, the patient should be reached as quickly as possible (optimally<20 min) and provided with on-site and en-route medical treatment according to international standards. The HEMS unit should be integrated into the Emergency Medical System of the region. All dispatchers should be aware of the specific problems encountered in mountainous areas. The nearest qualified HEMS team to the incident site, regardless of administrative boundaries, should be dispatched. The 'air rescue optimal crew' concept with its flexibility and adaptability of crewmembers ensures that all HEMS tasks can be performed. The helicopter and all equipment should be appropriate for the conditions and specific for mountain related emergencies. These recommendations, agreed by ICAR Medcom, establish recommendations for safe and effective HEMS in mountain rescue.

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Section: Dispatchingmentioning

confidence: 99%

Section: Timementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Medical Standards for Mountain Rescue Operations Using Helicopters: Official Consensus Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Tomazin

Ellerton

Reisten

et al. 2011

High Altitude Medicine & Biology

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“…In recent large studies, HT was a predictor of survival compared with ground transport (GT) [7,8]. The debate about the factors that could explain the impact of HT on survival remains open [9]. This benefit could be attributed to a higher level of competence in helicopter crews or to improved care provided at the destination centers [10-12].…”

Section: Introductionmentioning

confidence: 99%

Impact of emergency medical helicopter transport directly to a university hospital trauma center on mortality of severe blunt trauma patients until discharge

et al. 2012

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IntroductionThe benefits of transporting severely injured patients by helicopter remain controversial. This study aimed to analyze the impact on mortality of helicopter compared to ground transport directly from the scene to a University hospital trauma center.MethodsThe French Intensive Care Research for Severe Trauma cohort study enrolled 2,703 patients with severe blunt trauma requiring admission to University hospital intensive care units within 72 hours. Pre-hospital and hospital clinical data, including the mode of transport, (helicopter (HMICU) versus ground (GMICU), both with medical teams), were recorded. The analysis was restricted to patients admitted directly from the scene to a University hospital trauma center. The main endpoint was mortality until ICU discharge.ResultsOf the 1,958 patients analyzed, 74% were transported by GMICU, 26% by HMICU. Median injury severity score (ISS) was 26 (interquartile range (IQR) 19 to 34) for HMICU patients and 25 (IQR 18 to 34) for GMICU patients. Compared to GMICU, HMICU patients had a higher median time frame before hospital admission and were more intensively treated in the pre-hospital phase. Crude mortality until hospital discharge was the same regardless of pre-hospital mode of transport. After adjustment for initial status, the risk of death was significantly lower (odds ratio (OR): 0.68, 95% confidence interval (CI) 0.47 to 0.98, P = 0.035) for HMICU compared with GMICU. This result did not change after further adjustment for ISS and overall surgical procedures.ConclusionsThis study suggests a beneficial impact of helicopter transport on mortality in severe blunt trauma. Whether this association could be due to better management in the pre-hospital phase needs to be more thoroughly assessed.

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“…There has been an improved prognosis of patients with major trauma, acute myocardial infarction and acute stroke due to rapid provision of appropriate medical care by use of air transport. [ 16 17 18 ] The air transport is of two types:…”

Section: Key Elements Of Patient Transfermentioning

confidence: 99%

Inter-hospital and intra-hospital patient transfer: Recent concepts

2016

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The intra- and inter-hospital patient transfer is an important aspect of patient care which is often undertaken to improve upon the existing management of the patient. It may involve transfer of patient within the same facility for any diagnostic procedure or transfer to another facility with more advanced care. The main aim in all such transfers is maintaining the continuity of medical care. As the transfer of sick patient may induce various physiological alterations which may adversely affect the prognosis of the patient, it should be initiated systematically and according to the evidence-based guidelines. The key elements of safe transfer involve decision to transfer and communication, pre-transfer stabilisation and preparation, choosing the appropriate mode of transfer, i.e., land transport or air transport, personnel accompanying the patient, equipment and monitoring required during the transfer, and finally, the documentation and handover of the patient at the receiving facility. These key elements should be followed in each transfer to prevent any adverse events which may severely affect the patient prognosis. The existing international guidelines are evidence based from various professional bodies in developed countries. However, in developing countries like India, with limited infrastructure, these guidelines can be modified accordingly. The most important aspect is implementation of these guidelines in Indian scenario with periodical quality assessments to improve the standard of care.

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Urgent air-medical transport: Right patient, place and time

Cited by 17 publications

References 9 publications

Medical Standards for Mountain Rescue Operations Using Helicopters: Official Consensus Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Medical Standards for Mountain Rescue Operations Using Helicopters: Official Consensus Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Impact of emergency medical helicopter transport directly to a university hospital trauma center on mortality of severe blunt trauma patients until discharge

Inter-hospital and intra-hospital patient transfer: Recent concepts

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