Integration of aeromedicine in the response to the COVID-19 pandemic.

There is limited guidance on the use of helicopter medical personnel to facilitate care of critically ill COVID-19 patients. This manuscript describes the emergence of this novel virus, its mode of transmission, and the potential impacts on patient care in the unique environment of rotor wing aircraft. It details the development of clinical and operational guidelines for flight crew members. This allows other out-of-hospital clinicians to utilize our framework to augment or supplement their own for the current response effort to COVID-19. It further serves as a road map for future response to the care of high consequence infectious disease patients.

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.

Inter-hospital COVID ECMO air transportation.

The Coronavirus Disease 2019 (COVID-19) pandemic has required rapid and effective protocol adjustments at every level of healthcare. The use of extracorporeal membrane oxygenation (ECMO) is pivotal to COVID-19 treatment in cases of refractory hypoxemic hypercapnic respiratory failure. As such, our large, metropolitan air ambulance system in conjunction with our experts in advanced cardiopulmonary therapies modified protocols to assist peripheral hospitals in evaluation, cannulation and initiation of ECMO for rescue and air transportation of patients with COVID-19 to our quaternary center. The detailed protocol is described alongside initial data of its use. To date, 14 patients have been placed on ECMO support at an outside facility and successfully transported via helicopter to our hub hospital using this protocol.

[Air ambulance intensive care transport in prone position for COVID-19 ARDS]. / Luftgebundene Intensivverlegung in Bauchlage bei COVID-19-ARDS.

An EMS helicopter was scheduled to transport a woman with COVID-19 acute respiratory distress syndrome. However, the patient was found in prone position in the delivering hospital. After repositioning in the supine position, life-threatening hypoxemia occurred, so that the patient had to be returned to the prone position. After a structured decision making process, the patient could be transported with the helicopter without complications in prone position. Fortunately, the patient was stabilized in the further course of the disease and was transferred to a weaning facility breathing spontaneously with pressure support.