Peculiarities of Respiratory Support in Patients with Severe Pathology during Air Ambulance Evacuation

The aim of the study is to identify and to analyze the features of respiratory support in patients with severe acute respiratory failure when performing air ambulance evacuation by light class helicopters by specialists of aeromedical teams. Materials and methods. We used materials containing data on the frequency and peculiarities of ventilator usage and tracheal intubation during emergency medical care for patients with acute respiratory failure over the last 5 years (2016-2020). During this period emergency medical care was provided to 53579 patients, 298 of whom were in extremely severe and serious condition requiring ventilator usage and tracheal intubation. The following methods were used in the study: historical, statistical, analytical. Results of the study and their analysis. Trauma prevailed among nosological forms in patients with acute respiratory failure. Artificial lung ventilation with tracheal intubation should be started before the patient is transported to the helicopter cabin. During air ambulance evacuation of patients with acute respiratory failure by helicopter of light class, doctors should take differentiated approach to the choice of type and mode of respiratory support and of method of airway patency assurance.

URGENSI KEBERADAAN PERALATAN HELIKOPTER AMBULANS TENTARA NASIONAL INDONESIA ANGKATAN LAUT (TNI AL) DALAM MENDUKUNG SATUAN TUGAS CORONAVIRUS DISEASE-2019 (SATGAS COVID-19)

Pemerintah melalui Satuan Tugas Penanggulangan Covid-19 melaporkan total kasus Covid-19 di Indonesia hingga 16 Juli 2021, mencapai 2.780.803 orang sejak kasus pertama diumumkan. TNI Angkatan Laut (TNI-AL) selain melaksanakan tugas pertahanan juga membantu Satgas penanggulangan Covid-19 serta operasi kemanusiaan lainnya. Pelaksanaan tugas tersebut dilaksanakan oleh Pusat Penerbangan TNI AL (Puspenerbal). TNI Angkatan Laut belum pernah mengoperasikan Helicopter Air Ambulance (HAA) yang memiliki kemampuan Helicopter Emergency Medical Services (HEMS). Penelitian ini menggunakan pendekatan kualitatif dengan tempat penelitian di pusat penerbangan TNI Angkatan Laut (Puspenerbal) Juanda Sidoarjo Jawa Timur. Pengolahan data menggunakan model Miles, Huberman dan Saldan dengan tiga langkah yaitu pemadatan data, penyajian data, dan penarikan kesimpulan yang prosesnya dilakukan bersamaan. Pengumpulan data dengan metode menelaah dokumen dan informan. Penggunaan informasi pelaku lapangan dibatasi pada informan yang memiliki pengalaman operasi sebagai penerbang helikopter terkait subyek penelitian. Tujuan dari penelitian untuk memberikan gambaran tentang urgensi keberadaan peralatan helikopter ambulans TNI AL dalam mendukung satuan tugas coronavirus disease-2019. Adapun helikopter yang ditetapkan peneliti berjenis Bell-412 atau peralatan medical evacuation (Medevac portable) yang bisa dipasang pada helikopter jenis Bell-412 TNI AL. Temuan atau kebaharuan dari penelitian ini adalah dengan adanya helikopter Medevac TNI AL ini dapat melakukan tindakan penyelamatan darurat mengevakuasi korban ke RS terapung/KRI BRS milik TNI AL atau RSAL terdekat. Helikopter AL dipilih karena hanya penerbang helikopter TNI AL yang terlatih yang mendapatkan rekomendasi landing/mendarat di geladak heli KRI BRS TNI AL. Kesimpulan bahwa helikopter jenis Bell-412 sebagai ambulans udara dan peralatan Medevac portable-nya sangat dibutuhkan dalam membantu satgas covid-19 dan operasi kemanusiaan lainnya.

Management of Airways through Rapid Tracheostomy in a Severely Burnt Patient Attended to via Helicopter

In Catanzaro, Italy, an adult male with severe burns all over his body and in a state of coma was promptly rescued by the medical team at the air ambulance service (HEMS), who provided airway safety through laryngeal mask placement (LMA). The patient was subsequently transferred to the nearest Hub center, where an emergency tracheostomy was performed to ensure better airway management during the flight to the nearest available major burn center. This is the first documented case at regional level of a patient undergoing rapid tracheostomy through an imminent transfer with air ambulance.

Advantages and disadvantages of using helicopters for air medical evacuation of victims with traumas (literature review)

Relevance. To date, there are no clear criteria and optimal logistic conditions for the use of helicopters for the air medical evacuation of injured victims from the scene and from the emergency zone.Intention. To consider modern scientific views on the problem of using helicopters for air medical evacuation of victims from the place of injury.Methodology. PubMed database and eLIBRARY.ru platform were searched for publications from 2015 to 2020.Results and Discussion. The advantages of air ambulance evacuation by helicopters include shorter prehospital time, delivering victims from hard-to-reach areas directly to high-level trauma centers, and provision of extended prehospital care by highly qualified air medical teams. The use of helicopters is associated with risks to the life of the crew, requires significant financial costs and special equipment, and is limited by the lack of landing sites, weather conditions and at night. The effectiveness of the use of air ambulance helicopters depends on geographic and demographic factors, the level of injuries, the state of the road network in the region, the remoteness of ambulance stations, helicopter bases and trauma centers, the degree of interaction between rescue services and hospital specialists.Conclusion. The evacuation of casualties from the scene of the accident by helicopters of medical aviation can significantly reduce mortality in case of severe injuries.