Atendimento de Pacientes Neonatais Realizadas pelo Serviço Aeromédico: Uma Revisão Integrativa / Neonatal Patients Carried Out by Aerometric Service: An Integrative Review

Resumo: A remoção rápida e com medidas de segurança de recém-nascidos (RNs) críticos, como por exemplo, os prematuros extremos e os com malformações congênitas complexas, nascidos em centros que apresentam insuficiência de recursos para Unidades de Terapia Intensiva Neonatal (UTIs) por meio de transporte inter-hospitalar é considerada uma das recomendações do Ministério da Saúde devido sua capacidade de diminuição significativa da mortalidade neonatal por causas evitáveis. Objetivo: caracterizar o transporte neonatal através do Serviço Aeromédico Metódos: Trata–se de um estudo de revisão integrativa, com abordagem descritiva e exploratória, sobre o tema: Atendimento de Pacientes Neonatais realizadas pelo Serviço Aeromédico. Para a realização da busca na Biblioteca Virtual da saúde (BVS), foram utilizadas combinações entre as seguintes palavras-chave, consideradas descritores no DeCS: “Neonatologia”, “Resgate aéreo” e “Urgência”. Os termos foram cruzados como descritores e também como palavras do título e do resumo. A busca foi realizada no período de Junho de 2019.Resultados e discussão: A literatura o Serviço Aeromédico é utilizado principalmente entre RNs de alto risco, no qual existem indicações pré-estabelecidas e com isso possibilita a introdução de melhores abordagens. No qual é necessário a utilização de materiais e protocolos pré-estabelcidos, como também uma equipe preparada para realização dos atendimentos nos pacientes neonatais. Conclusão: Diante dessa perspectiva é possível compreender que o avanço tecnológico alinhado ao desenvolvimento de uma medicina de qualidade pode proporcionar melhores abordagens aos pacientes neonatais e com isso estabelecer uma melhor qualidade de vida e diminuição da morbimortalidade destes pacientes.Descritores: Neonatologia, Resgate aéreo, Urgência. Abstract:The rapid and safe removal of critical newborn infants (RNs), such as premature infants and those with complex congenital malformations, born in centers that have insufficient resources for Neonatal Intensive Care Units (ICUs) by means of interhospital transportation is considered one of the recommendations of the Ministry of Health due to its capacity to significantly reduce neonatal mortality from preventable causes. Objective: to characterize neonatal transport through the Aeromedical Service Metódos: This is an integrative review study, with a descriptive and exploratory approach, on the topic: Attendance of Neonatal Patients performed by the Aeromedical Service. In order to perform the search in the Virtual Health Library (VHL), we used combinations of the following keywords, considered descriptors in DeCS: "Neonatology", "Air Rescue" and "Urgency". The terms were cross-referenced as descriptors and also as title and abstract words. The search was performed in June 2019. Results and discussion: The literature the Aeromedical Service is mainly used among high risk NBs, in which there are pre-established indications and with this allows the introduction of better approaches. In which it is necessary to use pre-established materials and protocols, as well as a team prepared to perform care in neonatal patients. Conclusion: In view of this perspective, it is possible to understand that the technological advances aligned to the development of a quality medicine can provide better approaches to neonatal patients and thus establish a better quality of life and decrease of the morbimortality of these patients.Keywords: Neonatology, Air rescue, Urgency

Emergency Treatment of Anaphylactic Reactions in Air Rescue Missions: An Eight-Year Analysis of a German Rescue Helicopter Base

Introduction:Anaphylactic reactions can lead to a life-threatening situation. In the event of anaphylaxis, rapid and targeted emergency treatment is indicated.Study Objective:The study sought to determine the emergency therapy administered for anaphylaxis in children and adults. Focus was placed on therapy with adrenaline. In addition, the study aimed to investigate demographic data, triggers, and hospitalization rates of the different severities of anaphylaxis.Methods:A retrospective analysis of anaphylactic reactions was conducted using data from prehospital emergency missions performed by the Air Rescue Dresden/Germany from 2008 through 2015 using the standardized application protocol EPRO-5.0 (MIND 3) anonymized. Data from 152 adults and 29 children were evaluated, focusing especially on the acute treatment as well as demographic information, triggers, and symptoms of anaphylactic reactions.Results:In total, 152 adults (73 female, 79 male) from 18 to 87 years (mean 50.5 years) and 29 children (9 female, 20 male) from 1 to 16 years (mean 7.5 years) with anaphylactic reactions were analyzed. The most common trigger for severe anaphylactic reactions (Grade II-IV; classification modified according to Ring and Messmer) was food in children (33%) and insect venom in adults (59%). The data show that 19% of adults with Grade II-IV anaphylactic reactions (classification modified according to Ring and Messmer) received adrenaline. Regarding children, the appliance of adrenaline was only administered in seven percent of the cases of Grade II-IV anaphylactic reactions. Adults with Grade II or higher anaphylactic reactions were hospitalized in 92%. Three percent refused hospitalization and five percent were not transferred to hospital. One-hundred percent of the children with Grade II-IV anaphylaxis were hospitalized.Conclusions:Analysis of data from the Air Rescue Dresden/Germany shows that despite existing recommendations, only 19% of adults with severe anaphylaxis received adrenaline. Among children, only in seven percent was a treatment with adrenaline performed.On the other hand, all patients survived the acute emergency treatment without apparent adverse outcomes. Thus, further studies are needed to determine the proper use of adrenaline in anaphylactic reactions.

Polish Medical Air Rescue Crew Interventions Concerning Neonatal Patients

The purpose of the study was to present the characteristics of Helicopter Emergency Medical Service (HEMS) and Emergency Medical Service (EMS) interventions concerning newborns in Poland. The study involved a retrospective analysis of missions by Polish Medical Air Rescue crews concerning newborns, carried out in Poland between January 2011 and December 2020. Polish Medical Air Rescue crews were most commonly dispatched to urban areas (86.83%), for patient transfer (59.67%), using an airplane (65.43%), between 7 AM and 6:59 PM (93.14%), and in the summer (28.67%). Further management involved handing over the neonatal patient to a ground neonatal ambulance team. Most of the patients studied were male (58.02%), and the most common diagnosis requiring the HEMS or EMS intervention was a congenital heart defect (31.41%). The most common medical emergency procedure performed by Polish Medical Air Rescue crew members for the neonatal patients was intravenous cannulation (43.07%). The odds ratio for congenital malformations was higher in male newborns. The type of Polish Medical Air Rescue mission was associated with the location of the call, time of the call, ICD-10 diagnosis associated with the dispatch, selected clinical findings, most commonly performed medical emergency procedures, and mission duration and distance covered.

Preliminary Research of Air Rescue Services in the World and Improvement for the Slovak Republic

The paper tackles the development of air rescue services in the world, comparing their activities. It presents a general overview of the development history of these services from the beginning to today. It also deals with the economic demands of the operation of air rescue services. The intention and main goal of this paper were to analyze various solutions of air rescue service in selected states, organization of the rescue itself, including rescue in mountain terrain for the optimization of air rescue services in the Slovak Republic.

Vibration Properties of Steel Constructed Hospital Elevated Helipads

Polish Medical Air Rescue helicopters facilitate the rapid transport of patients to large hospitals. The requirements of the space around the helipad and the safety of flight operations mean that hospitals closer to city centers create more elevated helipads than ground-based helipads. The helipads can vary in the way they are constructed and located - depending on the possibilities offered by hospital buildings and their surroundings.Vibroacoustics Laboratory of the Institute of Aviation measured the vibration properties of some elevated helipads. The goal of this research was to determine the vibration properties of the helipads itself and the transmission of vibrations to the construction of the helipads, the building and its equipment caused by the landing and taking-off of a helicopter.This article presents some of the results of measurements of vibrations of steel constructed elevated helipads with the use of a modal hammer and while landing and taking-off of a helicopter, as well as comparison of the vibration properties concerning various elevated concrete helipads.

Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis

The aim of the study was to present characteristics of patients transported in incubators by crews of Helicopter Emergency Medical Service (HEMS) and Emergency Medical Service (EMS) of the Polish Medical Air Rescue as well as the character of their missions. The study was based on the method of retrospective analysis of neonatal transports with the use of transport incubators by the crews of HEMS and EMS of the Polish Medical Air Rescue. The study covered 436 medical and rescue transports of premature babies and full-term newborns in the period between January 2012 and December 2018. The study group consisted mainly of male patients (55.05%) who, on the basis of the date of delivery, were qualified as full-term newborns (54.59%). During the transport their average age was 37.53 (standard deviation, SD 43.53) days, and their average body weight was 3121.18 (SD 802.64) grams. A vast majority of neonatal transports were provided with the use of a plane (84.63%), and these were medical transports (79.36%). The average transport time was 49.92 (SD 27.70) minutes with the average distance of 304.27 km (SD 93.05). Significant differences between premature babies and full-term newborns were noticed in terms of age and body weight at the moment of transport, diagnosis based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the most commonly used medications (prostaglandin E1, glucose, furosemide, vitamins), National Advisory Committee for Aeronautics (NACA) scale rate as well as the mission type and the presence of an accompanying person.