Antarctic Evacuation: A Retrospective Epidemiological Study of Medical Evacuations on US Military Aircraft in Antarctica.

BACKGROUND: The international community has shown increasing interest in the Arctic and Antarctic due to the value polar regions have in terms of environmental research, natural resources, and national defense. The US Government maintains several permanent research and military facilities in polar regions. Medical evacuation (MEDEVAC) from these facilities can be limited for prolonged periods of time due to their extreme climates. Published data regarding MEDEVACs from these facilities is extremely limited. METHODS: Evacuations on military aircraft registered in the Transportation Command Regulation and Command and Control Evacuation System (TRAC2ES) database in a previously de-identified dataset were queried for events from McMurdo, Antarctica. The data was analyzed to determine the number of evacuations, reasons for evacuation, and additional demographic data. RESULTS: There were 31 evacuations from McMurdo Station and Scott Amundsen South Pole Station for 29 unique patients recorded in the available TRAC2ES dataset. Reasons for evacuation included traumatic brain/head injury, behavioral health concerns, extremity injuries, pregnancy, and various other medical/surgical concerns. CONCLUSIONS: MEDEVAC was typically required for advanced diagnostic/treatment modalities or if a patient could no longer fulfill his/her duties. Most evacuations were not directly related to environmental exposure. Given the climate in polar regions can preclude timely evacuation for large periods of time, the need for evacuation must be anticipated and mitigated whenever possible. Better data is needed to guide staffing and mission planning in this remote location.

A Pilot Medic-based Assessment of the Novel Handheld LifeFlow Device for Rapid Infusion of Blood Products.

INTRODUCTION: Uncontrolled hemorrhage remains the leading cause of preventable death in the prehospital, combat setting. Treatment guidelines emphasize immediate hemorrhage control and early resuscitation with whole blood or blood products. Current methods for the delivery of blood products are often insufficient to provide trauma resuscitation. The novel LifeFlow device is a hand-powered device that can rapidly infuse fluids, including blood products. However, successful use of this device in the hands of the intended end user has not been demonstrated. MATERIALS AND METHODS: We conducted a pilot study to assess how quickly and effectively medics could set up the LifeFlow device and infuse mock blood products into a casualty. They were provided with a brief block of instruction (<10 min) and the opportunity to handle the device. The time to set up the device and proportion of successful completion were recorded. Participants were surveyed regarding the use of the device including post-study interview. RESULTS: Forty medics, who were recruited and eligible to participate, completed the study procedures. All medics were able to successfully set up the device and perform the infusion. We had two instances of fluid leakage owing to malfunctions with the simulation arm, not the LifeFlow device. The mean time to device setup was 112 s (95% confidence interval [CI], 101-124). The mean time for infusion of 500 mL of fluid was 94 s (95% CI, 83-105). The mean time for all procedures was 197 s (95% CI, 178-213). On product feedback, they generally found it easier to use, easy to manipulate, possessing a useful grip, easily set up, and requiring minimal training. CONCLUSIONS: The medics were able to reliably assemble and use the LifeFlow rapid infusion device. However, there were concerns about the packaging and the single indication for the device.