Management of helicopter medical transport in 36 patients with critical cardiac disease / 中华危重病急救医学

Objective:To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.Methods:The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected.Results:Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely.Conclusion:Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.

Competencies for aeromedical evacuation practices in emergencies and disasters: a scoping review / Competencias para prácticas de evacuación aeromédica en emergencias y desastres: revisión del alcance / Competências para práticas de evacuações aeromédicas em emergências e desastres: revisão de escopo

ABSTRACT Objective: to map the competencies developed in training strategies for air transport practices for patients, in the face of emergency situations and disasters involving chemical, biological, radiological and nuclear (CBRN) agents. Method: this is a scoping review structured in accordance with the JBI and Preferred Reporting Items for Systematic reviews and Metanalyses extension for Scoping Reviews recommendations. The study was carried out in five stages: search for sources in 17 databases, an information portal and two repositories of gray literature, using 125 DeCS, MeSH and Emtree descriptors, without temporal and idiomatic clipping; selection; critical reading of the texts selected by two double-blind reviewers; summary of results and presentation of mapped competencies. Results: a total of 878 studies were analyzed, of which 18 composed the sample. In all, 11 competencies were mapped, with emphasis on the technical training domain. Competencies refer especially to technical-scientific knowledge in disaster situations involving CBRN agents and the safety of patients and professionals involved. Conclusion: the operationalization of artifices to improve qualification processes based on competencies proved to be strategic to increase the quality and safety of patient air transport practices. The approach of the sources on specific aspects of the particularities of practices related to emergencies and disasters involving CBRN agents in training/training processes demonstrates the academic effort to promote the reduction of the risk of these events when, in due course, civil and military institutions and their health operators are activated.

RESUMEN Objetivo: mapear las competencias desarrolladas en estrategias de formación en prácticas de transporte aéreo de pacientes, ante situaciones de emergencia y desastres con agentes químicos, biológicos, radiológicos y nucleares (QBRN). Método: una revisión de alcance estructurada de acuerdo con las recomendaciones del JBI y la lista de verificación Elementos de informe preferidos para revisiones sistemáticas y la extensión Metanalyses para revisiones de alcance. El estudio se realizó en cinco etapas: búsqueda de fuentes en 17 bases de datos, un portal de información y dos repositorios de literatura gris, utilizando 125 descriptores DeCS, MeSH y Emtree, sin recorte temporal e idiomático; selección; lectura crítica de los textos seleccionados por dos revisores doble ciego; resumen de resultados y presentación de competencias mapeadas. Resultados: se analizaron 878 estudios, de los cuales 18 compusieron la muestra. En total, se mapearon 11 competencias, con énfasis en el dominio de formación técnica. Las competencias se refieren especialmente al conocimiento técnico-científico en situaciones de desastres que involucran a agentes QBRN y la seguridad de los pacientes y profesionales involucrados. Conclusión: la operacionalización de artificios para mejorar los procesos de calificación basados ​​en competencias demostró ser estratégica para aumentar la calidad y seguridad de las prácticas de transporte aéreo de pacientes. El abordaje de las fuentes sobre aspectos específicos de las particularidades de las prácticas relacionadas con emergencias y desastres que involucran a agentes QBRN en los procesos de formación/capacitación demuestra el esfuerzo académico por promover la reducción del riesgo de estos eventos cuando, en su momento, se activan las instituciones civiles y militares y sus operadores de salud.

RESUMO Objetivo: mapear as competências desenvolvidas em estratégias de capacitação para práticas de transporte aéreo de pacientes, diante de situações de emergência e desastres envolvendo agentes químicos, biológicos, radiológicos e nucleares (QBRN). Método: revisão de escopo estruturada conforme as recomendações do Joanna Briggs Institute e do checklist Preferred Reporting Items for Systematic reviews and Metanalyses extension for Scoping Reviews. O estudo foi desenvolvido em cinco etapas: busca de fontes em 17 bases de dados, um portal de informação e dois repositórios de literatura cinzenta, utilizando 125 descritores DeCS, MeSH e Emtree, sem recorte temporal e idiomático; seleção; leitura crítica na íntegra dos textos selecionados por dois revisores em duplo cego; síntese dos resultados e apresentação das competências mapeadas. Resultados: foram analisados 878 estudos, dos quais 18 compuseram a amostra. Ao todo, foram mapeadas 11 competências, com destaque para o domínio capacitação técnica. As competências referem-se especialmente ao conhecimento técnico-científico em situações de desastre envolvendo agentes QBRN e à segurança do paciente e dos profissionais envolvidos. Conclusão: a operacionalização de artifícios para aperfeiçoar os processos de capacitação baseados em competências mostrou-se estratégica para elevar a qualidade e a segurança das práticas de transporte aéreo de pacientes. A abordagem das fontes sobre aspectos específicos das particularidades das práticas relacionadas às emergências e desastres envolvendo agentes QBRN em processos de formação/capacitação demonstra o esforço acadêmico de promover a redução do risco desses eventos quando, oportunamente, forem acionadas instituições civis e militares e seus operadores de saúde.

Impacto de las políticas públicas en el desarrollo de la industria del transporte aéreo. el caso de colombia / Impacto das políticas públicas no desenvolvimento do setor de transporte aéreo. o caso da colômbia / Impact of public policies on the development of the air transport industry. the case of colombia

Resumen Siguiendo la tendencia mundial y regional, Colombia liberalizó el sector o industria del transporte aéreo, a principios de década de 1990, y con ello dio inicio a una ininterrumpida (hasta el presente) batería de políticas públicas para dicho sector, paralelamente acompañadas de varias reformas a nivel institucional, todas ellas basadas en la concepción de que el estado colombiano considera el transporte aéreo un servicio público esencial, y que contribuye al desarrollo económico nacional. Por lo tanto, este trabajo, cuyo carácter es de análisis de un estudio de caso, presenta y analiza el impacto de las políticas públicas en el desarrollo y evolución de la industria del transporte aéreo en Colombia. Para ello el análisis se centra, por un lado, en el enfoque y planteamiento de las autoridades colombianas en el diseño e implementación de dichas políticas públicas, y por otro, en la evaluación del desarrollo y crecimiento del sector del transporte aéreo y su directa influencia en otras industrias relacionadas e indicadores socioeconómicos. El principal resultado de las políticas implementadas es: el alto y continuo crecimiento del tráfico aéreo, principalmente a nivel doméstico, lo que consolidó y fortaleció la conectividad y cohesión territorial; aportación a la riqueza nacional; generación de empleo; y apoyo a industrias muy relacionadas entre sí.

Resumo Seguindo a tendência mundial e regional, a Colômbia liberalizou o setor de transporte aéreo, ou indústria, no início da década de 1990, e assim deu início a uma bateria ininterrupta (até o momento) de políticas públicas para esse setor, acompanhada paralelamente por diversas reformas no nível institucional, todas baseadas no conceito de que o Estado colombiano considera o transporte aéreo um serviço público essencial e que contribui para o desenvolvimento econômico nacional. Portanto, este trabalho, cujo caráter é a análise de um estudo de caso, apresenta e analisa o impacto das políticas públicas no desenvolvimento e evolução da indústria do transporte aéreo na Colômbia. Para tanto, a análise se concentra, por um lado, na abordagem e abordagem das autoridades colombianas na formulação e implementação das referidas políticas públicas e, por outro, na avaliação do desenvolvimento e crescimento do setor de transporte aéreo e sua influência direta. em outros setores relacionados e indicadores socioeconômicos. O principal resultado das políticas implementadas é: o elevado e continuado crescimento do tráfego aéreo, principalmente a nível doméstico, que consolidou e reforçou a conectividade e a coesão territorial; contribuição para a riqueza nacional; geração de empregos; e apoio a setores intimamente relacionados.

Abstract Following the global and regional trend, Colombia liberalized the air transport sector at the beginning of the 1990s. This measure unleashed an uninterrupted (until now) set of public policies for the sector, accompanied by several reforms at the institutional level, all in the belief that the Colombian state considers air transport an essential public service that contributes to national economic development. This work uses the case study method to present and analyze the impact of public policies on the development and evolution of the air transport sector in Colombia. The analysis focuses on the approach of the Colombian authorities in the design and implementation of public policies, and the evaluation of the development and growth of the air transport sector and its direct influence on other related industries and socio-economic indicators. The main results of the implemented policies are: high and continued growth of air traffic, mainly at the domestic level, which consolidated and strengthened connectivity and territorial cohesion; contribution to national wealth; generation of employment; and support to closely related industries.

Study on air pressure changes in negative-pressure isolation capsule during casualty transport / 医疗卫生装备

Objective To prevent the medical personnel from infection during aeromedical evacuation of fulminating respiratory infectious disease patients by exploring the changes of differential pressure between those in and out of the negative-pressure isolation capsule and analyzing the stability of the capsule during aeromedical evacuation.Methods A differential pressure monitor developed by Institute of Medical Equipment was used for real-time recording of the changes the differential pressure in and out of the capsule during five flight phases of the aircraft,and the safety of the capsule during aeromedical evacuation and corresponding considerations were investigated.Results The maximum and minimum values of the negative pressure in the capsule were-60 Pa and-120 Pa respectively during aeromedical evacuation,which were all less than the safety threshold-15 Pa.The negative pressure was is directly proportional to the flying altitude.Conclusion The capsule keeps negative pressure effectively during flight,and thus facilitates patient aeromedial evacuation greatly.

Traslado aéreo civil de pacientes / Patients being transported by civil airline companies

Objetivo Las operaciones aéreas iniciaron en Colombia en 1919 pero no hay conocimiento sobre el traslado aéreo de pacientes en el país. El estudio fue realizado con empresas en Bogotá que realizaron traslados aéreos de pacientes durante los años 2005 a 2007. El objetivo es mejorar el conocimiento sobre las operaciones de traslado aéreo de pacientes en Colombia. Método Estudio descriptivo de los traslados aéreos de pacientes realizados por tres empresas durante los tres años seleccionados. La escala de valoración del riesgo para el transporte de pacientes fue usada en cada uno de los registros. Resultados Solo tres empresas autorizaron el acceso a los registros médicos, encontrando 98 en total, 24 en 2005, 28 en 2006, y 46 en 2007, pero solo se realizaron 96 traslados, debido a que dos fueron cancelados por malas condiciones médicas del paciente. Todos fueron traslados secundarios (entre hospitales) realizados en ala fija, es decir en avión, 61 % hombres, 38 % mujeres, 51 % adultos y 49 % fueron menores de 18 años (57 % neonatos). De acuerdo con la escala 27 % de los pacientes estaban inestables, 48 % moderadamente inestables y 25 % estables. El 90 % de los traslados fueron realizados por personal médico, 14 casos tuvieron complicaciones durante el vuelo pero la mortalidad fue solo del 4 %. Conclusiones El traslado aéreo de pacientes requiere una valoración y un registro completos de todas las variables relacionadas con el traslado y de personal entrenado en la atención de pacientes críticos de todas las edades.

Objective Colombian aviation operations began in 1919; however, no knowledge is currently available concerning medical air transport in the country. This study involved local companies in Bogota which provided air medical transfer for patients from 2005 to 2007; it was aimed at improving knowledge regarding air transport for patients in Colombia. Method This was a descriptive study of patient air transfer by three companies during the aforementioned three-year period. The Risk Score for Transport Patients' (RSTP) scale was used in each report. Results Only three companies authorized access to their medical reports; 98 reports were found, 24 in 2005, 28 in 2006 and 46 in 2007 but only 96 patients were transferred because two flights were cancelled because of the patients' poor medical condition. All the records dealt with secondary air transfer (between facilities) in fixed-wing aircraft. 61 % of the patients so transferred were male and 38 % female; 51 % were adults and 49 % were less than 18 years old (57 % of the latter being newborn). According to the RSTP scale, 27 % of the patients were unstable, 48 % moderately unstable and 25 % were stable. 90 % of the transfers were accompanied by medical staff, 14 cases had complications during their flights but mortality was just 4 %. Conclusion Patients' air transfer requires complete assessment and a complete record of all the variables related to transporting patients by air and personnel trained in dealing with critically-ill patients of all ages.

Progress of neonatal transport / 国际儿科学杂志

The transport of critical neonates has a high mortality. To reduce the mortality, it is very important to determine the transport indications in advance. Additionally, the neonatal transport is also based on the industrial training, the transport team combined by a variety of profession, the uniform and standard transport equipment and so on. Therefore, this article mainly reviews the education training, team, equipment, indications, the latest skill, air transport and so on.

Sisteg®-Sistema de transporte para muestras diagnósticas y sustancias infecciosas / Sisteg®-Transport system for biological material and infectious substances

El propósito de este trabajo es presentar un envase que cumple con las regulaciones de seguridad tanto para el transporte de muestras diagnósticas como el de sustancias infecciosas, basado en las Normas IATA (Asociación de Transporte Aéreo Internacional), en las Recomendaciones para el Transporte de Muestras Peligrosas de Naciones Unidas y en las legislaciones internas vigentes. Este envase logra dar tranquilidad a todos los sectores involucrados en un transporte de muestras: personal del laboratorio derivante, de la empresa de transporte y del laboratorio efector, además de minimizar el riesgo de contaminación del medio ambiente y de la población en general. Por otro lado, también se buscó asegurar la integridad de la muestra, realizando un transporte seguro y eficiente, cuidando la cadena del frío cuando fuese necesario, para permitir un análisis exacto por parte del laboratorio destinatario. Para todo esto se contó con la participación del Instituto Nacional de Tecnología Industrial (INTI) el que una vez realizados todos los ensayos, elaboró un documento con los resultados, que permitió a la Comisión de Prevención de Accidentes en la Aviación Civil (PREVAC) -organismo dependiente de las FFAA- determinar que dicho Sistema puede ser utilizado para el envío sin riesgo por vía aérea tanto de muestras diagnósticas como de sustancias infecciosas.

The purpose of the work is to introduce a package that fulfills the safety guidelines for transportation of Diagnostic Specimens as well as Infectious Substances, based on the IATA (Internacional Air Transport Association) Standards, the United Nations Recommendations on the Transport of Dangerous Goods and the internal legislation in force. In this way, none of the sectors involved in Specimen Transportation should not be worried since shipping laboratory personnel, carrier personnel, the receiving laboratory personnel, and, additionally, the risk of polluting the environment or the population in general are minimized. Besides, specimen integrity has been intended to be ensured, by providing safe and efficient transport, taking care of the cold chain when required, in order to obtain an accurate analysis from the receiving laboratory. For this purpose, upon completion of the tests, the Instituto Nacional de Tecnología Industrial (INTI - National Institute of Industrial Technology) enabled the Comisión de Prevención de Accidentes en la Aviación Civil (PREVAC - Commission for the Prevention of Civil Aviation Accidents) --dependent on the Air Forces- to set out that said System can be used for sending diagnostic specimens and infectious substances whithout risk by air mail.