Retour d'expérience des six évacuations sanitaires aériennes collectives MoRPHEE durant la pandémie de Covid-19

Après son apparition en Chine à la fin de 2019, l'épidémie de coronavirus 2019 (Covid-19) a rapidement provoqué le risque d'une saturation des ressources en soins intensifs dans chaque pays touché. La répartition de la maladie entre les différents territoires est hétérogène. Le transport interhospitalier sur longue distance de patients atteints de Covid-19 dans le but de limiter la pression sur les unités de soins intensifs au niveau national ou international n'a pas encore été décrit. L'objectif de cet article était de fournir des données descriptives des six missions d'évacuation aéromédicale collective (Evasan) de patients atteints de Covid-19 réalisées en Europe et sur le territoire national français les 18, 21, 24, 27, 31 mars et 3 avril 2020 grâce au dispositif MoRPHEE. Trente-six patients souffrant de syndrome de détresse respiratoire aiguë (SDRA) ont été évacués durant six missions d'évacuations sanitaires collectives. Le SDRA était modéré (rapport PaO2/FiO2 > 100 et ≤ 200) chez 24 patients et léger (rapport PaO2/FiO2 > 200 et ≤ 300) chez 12 patients. La durée médiane de la ventilation mécanique en soins intensifs avant le transport était de quatre jours (interquartile [IQ] : 3‒5). Le rapport médian PaO2/FiO2 était de 180 mmHg (IQ : 156‒202). Le débit médian de perfusion de noradrénaline était de 0,08 μg/kg par min. Aucune complication mettant en jeu le pronostic vital n'a été signalée. En conclusion, l'évacuation sanitaire aérienne collective de patients gravement malades de Covid-19 est une solution contribuant à contrôler le niveau de saturation du système de soins au niveau national ou international.Alternate : Since its emergence in China in late 2019, the coronavirus disease 2019 (COVID-19) outbreak has rapidly posed the risk of critical care resources overload in every affected country. The distribution of the disease among the territories is heterogeneous. Long-range inter-hospital transport of critically ill COVID-19 patients as a way to mitigate the localised pressure from overloaded intensive care units at a national or international level has not been reported yet. The aim of this article was to provide descriptive data about the six collective aeromedical evacuation of COVID- 19 patients performed within Europe and French national territory on March 18, 21, 24, 27, 31 and April 3, 2020. Thirty-six patients with acute respiratory distress syndrome (ARDS) were transported aboard six aeromedical evacuation missions. ARDS was moderate (PaO2/FiO2 ratio > 100 and ≤ 200) in 24 patients and mild (PaO2/FiO2 ratio > 200 and ≤ 300) in 12 patients. The median duration of mechanical ventilation in ICU before transportation was 4 days [Interquartile (IQ): 3–5]. The median PaO2/FiO2 ratio was 180 mmHg (IQ: 156–202). The median norepinephrine infusion rate was 0.08 μg/kg/min. No life-threatening event was reported. Collective aeromedical evacuation of COVID-19 critically ill patients could provide a reliable solution to help control the burden of the disease at a national or international level. Future works may evaluate the global safety and effectiveness of aeromedical evacuations in this context.

Editorial for Vol 32, No 3

In Vol. 32, No. 3, our journal prepared 1 original article, 2 review articles, and 1 brief report. Space science need to be considered not only from the point of intellectual curiosity, but also from the profit. Space medicine is one of the core of national competitiveness, and gravity and cosmic radiation are major research areas in this field. The aftereffects of corona virus infection can affect aviation safety. An evaluation of this is essential before returning to the workplace. The first International Conference of Aerospace medicine 2022 was held in Paris. Various topics were discussed in depth. In particular, the inequality of corona virus vaccines supply, the application of digital health to tracking infected people, and the development of corona virus infection prediction algorithms were impressive. Japan and South Korea were compared for the current status of Zika virus. This difference appears to be mainly due to preferred travel destinations and their climates. [ FROM AUTHOR]

Long COVID and Aviation Safety

Since its emergence in Wuhan, China, COVID-19 has spread and had a profound effect on the lives and health of people around the globe. Most people who develop COVID-19 fully recover, but current evidence suggests approximately 10% to 20% of people experience a variety of mid- and long-term effects after they recover from their initial illness. These mid- and long-term effects are collectively known as post covid-19 condition or "long COVID". Studies have shown that a significant number of patients complain of multiple symptoms over a period of several months or longer. The symptoms of long covid include fatigue or muscle weakness, dyspnea, cognitive impairment, and depression or anxiety. These chronic symptoms can also negatively affect aviation safety. Therefore, this review summarizes studies of the long-term effects of COVID-19, and aeromedical implications of long COVID. [ FROM AUTHOR]

편집자 주: 32권 2호

In Vol. 32, No. 2, our journal prepared 3 original articles, 3 review articles, and 1 brief report. A Survey of the laboratory tests item was conducted during aviation medical examination based on the 27 hospitals. The following items were implemented in all institutions, but other items was different by institution. Urine test, ophthalmic test (except fundus test), fasting blood sugar, complete blood cell count, electrocardiogram, electoencephalography, chest X-Ray, pure tone audiometry, and total cholesterol. The impact of COVID-19 on the flight training of student pilots was analyzed through a survey. On the positive side, fewer commercial flights and fewer flights mean more opportunities for students to train. Fewer face-to-face classes have freed up more time for self-care. In other words, students were able to plan and control their exercise, self-study, rest, and sleep time on their own. On the negative side, social distancing prevented them from riding in the back seat, leaving them less chance to get used to the cockpit. [ FROM AUTHOR] Copyright of Korean Journal of Aerospace & Environmental Medicine is the property of Aerospace Medical Association of Korea and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Telerehabilitation: An Overview

Rehabilitation is a major component of health sciences, and is the process of restoring an incapacitated individual to a normal life through training and therapy. Globally, 2.4 billion people may currently require rehabilitation. In 60 to 70% of countries, existing rehabilitation services have been disrupted due to the coronavirus disease 2019 (COVID-19) pandemic. Even after lockdowns and with vaccinations, some form of physical distancing is likely to be part of the new normal. Concurrently, there is an exponential growth of telehealth. This global overview will demonstrate that telerehabilitation (TR) is likely to be a distinct stand-alone sub-specialty of telehealth. Details of setting up TR, methods, and components are discussed, and clinical indications, limitations, advantages, disadvantages, challenges, and barriers to implementation and technological advances in TR are highlighted followed by an in-depth study of the literature from India.

Evaluation of fatigue and sleep problems in cabin crews during the early COVID-19 pandemic period.

BACKGROUND: The COVID-19 outbreak has affected the aviation sector. The anxiety and fear caused by this newly emerging virus, whose effects are not fully known in the short and long term, may also cause problems in terms of flight safety. We aimed to evaluate fatigue and sleep problems associated with fear of COVID-19 during the early pandemic period in cabin crew. METHODS: This is a cross-sectional survey study consisting of 45 questions in total. Participants were cabin crew members on flight duty. An online questionnaire was sent to 2092 cabin crew in February-April 2021 via TASSA Cabin Crew Member's Association. The survey included questions about socio-demographic characteristics, flight times, flight types and COVID test history, as well as the international physical activity questionnaire-short form (IPAQ-SF), fatigue severity scale (FSS), Jenkins sleep scale (JSS) and fear of COVID-19 scale (FCV-19S). RESULTS: Out of 316 survey results obtained (response rate, 15%), 225 (71%) were included in the study, with a mean age (SD) of 32.54 (4.91) years, and 124 (55.1%) were women. According to IPAQ-SF, 27.6% of cabin crew were found to be inactive, 54.7% minimally active and 17.7% very active. According to FSS, pathological fatigue was found in 43.6%. The FSS score of the inactive group was higher than the others (Kruskal Wallis, p < 0.001). As the number of people living in the same house or flight time in the last 1 month increase, the fear of COVID-19 also increases (Spearman, p = 0.01 r = 0.171, and p = 0.049 r = 0.131). In addition, there was direct correlation between fear of COVID-19 and fatigue and sleep problems (Spearman, p = 0.001 r = 0.218, and p < 0.001 r = 0.26, respectively). CONCLUSION: This study shows that fatigue and sleep problems increase as the fear of COVID-19 increases in cabin crew during the early pandemic period. Consequently, precautions and further studies are needed, as fatigue and sleep disorders may primarily be related to the anxiety, fear and uncertainty surrounding the COVID-19 pandemic.

Current Status of Foreign Patients in a Hospital over the Past 6 Years and the Impact of COVID-19.

Purpose: As it becomes difficult to move between countries due to the spread of COVID-19, it can be expected that the number of foreign patients entering Korea for treatment will decrease significantly. The purpose of this study is to investigate the current status of hospitalization of foreign patients over the past 6 years and the impact of COVID-19. Methods: The sex, age, nationality, and histories of foreign patients who visited the International Medical Center from 2016 to 2021 were collected. A total of 25,569 subjects were analyzed. Results: For six years from 2016 to 2021, the number of foreign patients increased steadily before COVID-19 but decreased significantly after COVID-19. Overall, it was analyzed that the average annual growth rate of foreign patients from 2016 to 2019 was about 6%. However, due to the impact of COVID-19, the number of patients in 2020 decreased by about 57% compared to the previous year and by about 1% in 2021 compared to the previous year. Conclusion: It is believed that the decrease in foreign patients in a situation such as Corona 19 is due not only to the risk of infection, but also to the difficulty of moving between countries. In other words, it can be said that the driving force for the movement due to the medical skill gap still exists. Therefore, if this situation improves, it is judged that the phenomenon of moving abroad in search of medical care is inevitable. [ FROM AUTHOR] Copyright of Korean Journal of Aerospace & Environmental Medicine is the property of Aerospace Medical Association of Korea and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Aviator Occupational Behavior Surrounding COVID-19 Infection and Vaccination in the United States: A Cross-Sectional Population-Based Survey.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has precipitated change across the aviation industry, including aeromedical standards. U.S. pilot occupational behavior regarding COVID-19 infections and vaccinations have not been well-studied. Methods We conducted an anonymous survey of 661 U.S. pilots from September 1, 2021, through December 15, 2021. Results We found 23.8% of pilots reported a history of COVID-19 infection but only 20.5% of infected pilots reported this history to an aeromedical examiner (AME)/flight surgeon. Of uninfected pilots, 50.5% reported being either extremely unlikely or somewhat unlikely to disclose a new infection to an AME/flight surgeon. Seventy-nine point six percent (79.6%) of pilots received at least one dose of any COVID-19 vaccine and 89.6% of those who received a vaccine complied with the 48-hour no-flying policy. Of the unvaccinated pilots, 74.5% reported being either extremely unlikely or somewhat unlikely to receive a vaccine.

Advanced Air Mobility: Opportunities and Challenges Deploying eVTOLs for Air Ambulance Service

Advanced air mobility (AAM) is a broad concept enabling consumers access to on-demand air mobility, cargo and package delivery, healthcare applications, and emergency services through an integrated and connected multimodal transportation network. While a number of technical and social concerns have been raised about AAM, early use cases for emergency response and aeromedical transport may be key to demonstrating the concept and building public acceptance. Using a five-step multi-method approach consisting of preliminary scoping, modeling performance metrics, developing baseline assumptions, analyzing scenarios, and applying a Monte Carlo sensitivity analysis, this study examines the potential operational and market viability of the air ambulance market using a variety of aircraft and propulsion types. The analysis concludes that electric vertical take-off and land (eVTOL) aircraft could confront a number of operational and economic challenges for aeromedical applications compared to hybrid vertical take-off and land (VTOL) aircraft and rotorcraft. The study finds that technological improvements such as reduced charge times, increased operational range, and battery swapping could make the eVTOL aircraft more reliable and cost-effective for aeromedical transport.