U.S. Navy Aeromedical Missions from 20162019 with a Focus on En Route Care Provider Type

2021 ◽  
Vol 92 (11) ◽  
pp. 873-879
Author(s):  
Sadie M Henry ◽  
Mark M Stanfield

BACKGROUND: En route care (ERC) is a military aeromedical mission designed to transport a patient to a higher level of care. With the exception of one manual, there are no other formal Navy ERC guidelines, leaving the service to provide such missions ad hoc. Based on the authors review of available literature, it seems no prior research has been done on Navy rescue swimmers performing ERC, though many search and rescue (SAR) missions take place without designated medical personnel. This study specifically examines the type of provider involved in Navy ERC missions and the types of cases involved with the purpose of influencing Navy policy.METHODS: A cross-sectional study examining 829 air evacuations performed by Navy SAR flight crews from 2016 to 2019 was analyzed.RESULTS: Of 829 cases reviewed, patients were more likely to be active-duty personnel (51%) than civilian (47%), and there were 2.5 times more male than female patients. There were more trauma (54%) than medical (43%) patients, with Basic Life Support (BLS) level care (60%) delivered twice as often as Advanced Life Support (ALS) (28%). Search and Rescue Medical Technicians (SMTs) and rescue swimmers provided 83% of ERC, with rescue swimmers supporting 33% of all ERC missions alone.DISCUSSION: The results of this study are in contrast to previous ERC studies, in which rescue swimmer-only transports were excluded from the data. The results raise the question, do rescue swimmers need to be trained to a higher level of care?Henry SM, Stanfield MM. U.S. Navy aeromedical missions from 20162019 with a focus on en route care provider type. Aerosp Med Hum Perform. 2021; 92(11):873-879.

2019 ◽  
Vol 13 ◽  
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins

Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors:  Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado. 


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kasper G Lauridsen ◽  
Anders S Schmidt ◽  
Philip Caap ◽  
Rasmus S Aagaard ◽  
Bo Løfgren

Introduction: The quality of in-hospital resuscitation is poor and may be affected by clinical experience and cardiopulmonary resuscitation (CPR) training. This study aimed to investigate the clinical experience, self-perceived skills, CPR training, and knowledge of guidelines on when to abandon resuscitation among physicians on cardiac arrest teams. Methods: This is a nationwide cross-sectional study in Denmark. Telephone interviews were performed with physicians on cardiac arrest teams in public somatic hospitals. Telephone interviews were performed using a structured questionnaire. Results: In total, 93 physicians (53% male) from 45 hospitals participated. Median age was 34 interquartile range (30-39) years. Participants were medical students working as locum physicians (5%), residents and fellows (79%), chief physicians (16%), and median postgraduate clinical experience was 48 (19-87) months. Most physicians (92%) felt confident in treating a cardiac arrest, while less felt confident in performing intubation (41%) and focused cardiac ultrasound (39%) during cardiac arrest. Median time since last CPR training was 4 months (2-10) and 48% had attended a European Resuscitation Council (ERC) Advanced Life Support (ALS) course. The majority (84%) felt confident in terminating resuscitation however only 9% were able to state ERC guidelines on when to abandon resuscitation. Conclusions: Physicians on Danish cardiac arrest teams are most often non-specialists with four or less years of clinical experience. Several physicians are not able to perform important clinical skills during resuscitation. Less than half of physicians have attended an ERC ALS course. Only very few physicians know the ERC guidelines on when to abandon resuscitation.


Author(s):  
Verónica V. Márquez-Hernández ◽  
Lorena Gutiérrez-Puertas ◽  
Alba García-Viola ◽  
José Miguel Garrido-Molina ◽  
Vanesa Gutiérrez-Puertas ◽  
...  

2020 ◽  
Vol 7 (45) ◽  
pp. 2640-2644
Author(s):  
Sunil R ◽  
Praseetha V.K

BACKGROUND The knowledge and skills in Cardio-Pulmonary Resuscitation (CPR) is an essential part in the medical education. Resuscitation skills have undergone series of evolution into current protocol which involves Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). We wanted to assess the awareness of Basic Life Support among medical students, nursing students and house surgeons in a Government Medical College in Kerala. METHODS A cross-sectional study was conducted by assessing responses to 24 selected basic questions regarding BLS and ACLS among the students. After excluding the incomplete response forms the data from 500 responders was analysed. Results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual of AHA (2015). RESULTS Out of 500 responders, 250 were medical students, 100 were nursing students and 150 were House Surgeons. No one among them had complete knowledge of BLS & ACLS. Awareness of BLS & ACLS among students of medical, and nursing colleges and doctors is poor. Regarding knowledge of BLS (9 questions) the analysis of results showed that mean percentage of correct responses were 75.67 % of house surgeons, 51.78 % of nursing students and 20.98 % of medical students. CONCLUSIONS Awareness of BLS among students of medical, and nursing colleges and house surgeons is inadequate. Proper training programs must be initiated to rectify this. KEYWORDS BLS & ACLS Awareness, Medical Students, CPR Questionnaire


Author(s):  
Andi Ade Wijaya Ramlan ◽  
Adhrie Sugiharto ◽  
Agus Mutakim

BACKGROUND The pediatric advanced life support (PALS) method can predict the depth of endotracheal tube (ETT) in pediatric patients easily, but it has limitations due to variations in the children’s characteristics, especially the racial consideration. This study compared the accuracy of ETT depth prediction based on the PALS methods in Indonesian children. METHODS Patients aged 0–12 years, who underwent elective surgery with oral intubation, were recruited consecutively based on their ages: 0–24 months and 25 months–12 years for this cross-sectional study in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to August 2014. Bland–Altman analysis was used to compare the two measurement methods: PALS method to predict the ETT depth accuracy and auscultation method to confirm the position of the ETT. Furthermore, correlation analysis was done to examine the relationship of age, weight, height, and ETT internal diameter with ETT depth. RESULTS 50 patients were recruited in each group. Bland–Altman test of ETT depth in the 0–24 months age group showed a 1.18 cm mean difference from confirmation using the auscultation method (limits of agreement −0.71 to 3.08). The 25 months–12 years age group showed a 1.11 cm mean difference with limits of agreement were −0.95 to 3.17 from confirmation using the auscultation method. Age and weight had the strongest correlation value to ETT depth in the 25 months–12 years age group (R2 = 62.3%). CONCLUSIONS The PALS method is inaccurate for predicting ETT depth in Indonesian children aged 0–12 years old compared with the auscultation method.


Author(s):  
Elsa María Rodríguez Angulo ◽  
Uc Santos Guillermo ◽  
Gómez Carro Salvador

Objective: Describe the clinical and sociodemographic characteristics of maternal deaths that occurred in a hospital in Yucatán, Mexico, as well as propose recommendations to improve the care of pregnant women in order to help reduce in-hospital maternal mortality. Material and methods: Retrospective, cross-sectional study conducted in a second-level care concentration hospital. The hospital database of maternal deaths that occurred during the 2014–2018 period was reviewed, as well as clinical summaries, maternal death reports, maternal death ratification forms, and hospital records. Results: There were 54 maternal deaths, the year with the highest percentage was 2018 with 15 (27.8%) deaths. Most of the women resided in municipalities with low and very low degrees of marginalization 23 (42.6%); 48 (88.9%) were engaged in housework; 13 had a history of previous abortion (24.1%), with prenatal control 18 (33.3%), used some contraceptive method 13 (24.1%); and 21 (38.9%) presented some complication during pregnancy. Direct maternal deaths were mainly hypertensive disorders with 9 (32.1%) deaths. Indirect maternal deaths were mainly due to heart disease and arteriovenous disorders 6 (30.0%). The Hospital Mortality Committee issued 98 (55.1%) recommendations to improve emergency care, of which 32 (32. 6%) were related to the training of health personnel in the first level of care; and 22 (22.5%) for the second level of care. Conclusion: It is important to improve the care of the pregnant woman through the permanent training of health personnel to detect warning signs in the prenatal consultation and care of the obstetric emergency, in order to fully detect the problems that arise in the care chain of patients. Likewise, the training and updating of medical personnel for the correct completion of the basic causes of maternal death according to IDC-10 will be necessary for the correct certification of deaths.


Author(s):  
Siddharth Dixit ◽  
Sirjana Dahal ◽  
Punam Basnet Dixit ◽  
Geshu Lama

 Introduction: Survival after sudden cardiac arrest depends upon early intervention, quality of cardiopulmonary resuscitation (CPR) and time of defibrillation. So, it is very important that at least the medical personnel know about Basic Life Support (BLS) as they are frequently facing the life threatening situations. Objective: To assess the level of awareness regarding adult basic life support among graduates in a medical college of Kathmandu. Methods: A descriptive cross-sectional study was conducted after ethical approval in Kathmandu Medical College and Teaching Hospital from April to September 2018 among 150 medical and dental graduates including interns and dental/medical officers. A structured self-administered questionnaire was used to assess their awareness regarding Adult BLS. Data were entered and analysed in Microsoft Excel Sheet. Mean, standard deviation, frequency, and percentage were calculated. Results: Most of the graduates surveyed (122, 81.3%) had heard about Adult BLS and felt the need to know about it (142, 94.7%). They felt the necessity including BLS training as a part of medical curriculum (144, 96%). Some of them (58, 38.7%) had seen BLS being done. However, very few (2, 1.3%) had actually done BLS on a patient. Some (54, 36%) had attended workshop on BLS. Conclusion: The findings of the study concluded that although most of the medical and dental graduates felt the need, very few had attended workshop for BLS. The BLS training should be included in the medical curriculum so that the graduates would be able to effectively manage the life-threatening emergencies.


2018 ◽  
Vol 12 (7) ◽  
pp. 1912
Author(s):  
Robson Cristiano Zandomenighi ◽  
Eleine Aparecida Penha Martins

Robson Cristiano Zandomenighi1, Eleine Aparecida Penha Martins2RESUMOObjetivo: analisar as características epidemiológicas das vítimas e ocorrências de parada cardiorrespiratória em ambiente pré-hospitalar e seus desfechos. Método: estudo quantitativo, epidemiológico e transversal, com as vítimas atendidas pelas unidades de suporte avançado de vida, submetidas à reanimação cardiopulmonar. Coletados os dados no relatório de atendimento do socorrista e realizada análise estatística a partir do Microsoft Office Excel e do Software SPSS 20.0.   Resultados: houve 163 atendimentos, mediana de idade de 65 anos, predominando o sexo masculino, com hipertensão arterial e diabetes mellitus. A causa clínica e a assistolia foram mais prevalentes, havendo mais ocorrências na região central, durante o outono, no período noturno. O tempo-resposta da ambulância foi menor na região central. A duração do atendimento demonstrou associação com o desfecho, sendo maior entre os sobreviventes. O principal destino dos sobreviventes foram hospitais terciários. A taxa de sobrevida imediata foi de 25,1%. Conclusão: idosos com comorbidades foram as principais vítimas, havendo elevada taxa de mortalidade. Verificou-se a importância de uma resposta rápida e eficaz do serviço de emergência. Descritores: Parada Cardíaca Extra-Hospitalar; Reanimação Cardiopulmonar; Epidemiologia; Serviços Médicos de Emergência; Ambulâncias. ABSTRACT Objective: to analyze the epidemiological characteristics of victims and occurrences of cardiorespiratory arrest cases in a prehospital environment and their outcomes. Method: this is a quantitative, epidemiological and cross-sectional study with victims assisted in advanced life support units and submitted to cardiopulmonary resuscitation. Data were collected from the report of the rescue team. The the Microsoft Office Excel and SPSS 20.0 software were used for statistical analyses. Results: there were 163 cases, the median age of the victims was 65 years, they were predominantly male, and presented hypertension and diabetes mellitus. Clinical cause and asystole were more prevalent, with more occurrences in the central region, during the fall, at night. The ambulance response time was lower in the central region. The duration of care was associated with the outcome, being higher among survivors. The main destination of survivors was tertiary hospitals. The immediate survival rate was 25.1%. Conclusion: elderly patients with comorbidities were the main victims, with a high mortality rate. It was verified the importance of a rapid and effective response from the emergency service. Descriptors: Extra-Hospital Cardiac Arrest; Cardiopulmonary resuscitation; Epidemiology; Emergency Medical Services; Ambulances.RESUMEN Objetivo: analizar las características epidemiológicas de las víctimas y ocurrencias de parada cardiorrespiratoria en ambiente pre-hospitalario y sus desenlaces. Método: estudio cuantitativo, epidemiológico y transversal, con las víctimas atendidas por las unidades de soporte avanzado de vida, sometidas a la reanimación cardiopulmonar. Los datos fueron recogidos en el informe de atención del socorrista y fue realizado el análisis estadístico a partir del Microsoft Office Excel y del Software SPSS 20.0.   Resultados: hubo 163 atendimientos, mediana de edad de 65 años, predominando el sexo masculino, con hipertensión arterial y diabetes mellitus. La causa clínica y la asistolia fueron más prevalentes, habiendo más ocurrencias en la región central, durante el otoño, en el período nocturno. El tiempo-respuesta de la ambulancia fue menor en la región central. La duración del atendimiento demostró asociación con el desenlace, siendo mayor entre los sobrevivientes. El principal destino de los sobrevivientes fueron hospitales terciarios. La tasa de sobrevida inmediata fue de 25,1%. Conclusión: ancianos con comorbilidades fueron las principales víctimas, habiendo elevada tasa de mortalidad. Se verifico la importancia de una respuesta rápida y eficaz del servicio de emergencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Epidemiología; Servicios Médicos de Urgencia; Ambulancias.  


2016 ◽  
Vol 15 (1) ◽  
pp. 66-69
Author(s):  
Shanti Bajracharya ◽  
Liza Nagarkoti

Introduction: Basic life support (BLS) is an emergency procedure that consists of recognizing an arrest and initiating proper cardio pulmonary resuscitation (CPR) techniques to maintain life until victims either recovers or is transported to medical facility where advanced  life support are available. It is very important that all nurses know about basic life support to save lives of patients. Methods: A descriptive cross-sectional study was conducted in 50 nurses working in various intensive and high care units of our teaching hospital to assess their Knowledge on BLS. Non-probability purposive sampling technique was used for data collection for which self-administered semi-structured questionnaire was used. Results: Majority (46%) of the respondents were between 20 to 25 years of age. 52% of respondents were of Proficiency Certificate Level (PCL), 36 % of bachelor of nursing (BN) and 12% Bachelor of Science in Nursing (B.Sc Nursing). 36% respondents had working experience of 5-10 years and 6% of 10-15 years. All respondents had heard about BLS but 86% of them had never attended any BLS training. Most of the respondents (86 %) had seen CPR being done and more than half of the respondents (58%) had done CPR. 62% stated circulation, airway and breathing as the latest CPR sequence. 90% of the respondents said cardiac arrest is the indication of CPR. 66 % had inadequate knowledge, 32%  had moderate knowledge while minority 2 %  had adequate knowledge on Basic Life Support.Conclusion: Knowledge of Basic Life Support (BLS) among Nepalese nurses was inadequate in majority of cases. There was also no association between the knowledge and academic qualification or experience.


2021 ◽  
Vol 36 (3) ◽  
pp. 295-300
Author(s):  
Adeviyye Karaca ◽  
Kamil Can Akyol ◽  
Mustafa Keşaplı ◽  
Faruk Güngör ◽  
Umut Cengiz Çakır ◽  
...  

AbstractIntroduction:The aim of this study was to investigate the usability of the age value listed on the labels on children’s clothes in the age-based weight estimation method recommended by the Pediatric Advanced Life Support (PALS) guidelines.Material-Method:This prospective, cross-sectional study was organized in Antalya Training and Research Hospital Emergency Department. Children aged between 1-12 years were included in the study. The weight measurements of the children were obtained based on the age-related criteria on the labels of their clothes. The estimated values were compared with the real values of the cases measured on the scale.Results:One-thousand ninety-four cases were included, the mean age of cases in age-based measurements was 6.25 years, which was 6.5 years in label-based measurements. Average weights measured 25.75kg according to age-based measurements, 26.5kg according to label-based measurements, and 26.0kg on the scales, and showed no statistical difference (P <.0001). It was estimated that 741 (67.7%) of age-based measurements and 775 (70.8%) of label-based measurements were within (±)10% values within the normal measurement limits and no significant difference was measured.Conclusion:In the emergency department and prehospital setting, children with an unknown age and that need resuscitation and interventional procedures for stabilization, and have no time for weight estimation, checking the age on clothing label (ACL) instead of the actual age (AA) can be safely used for the age-dependent weight calculation formula recommended by the PALS guide.


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