阿尔及利亚地震灾后中国危重伤员远程空中转运

目的 总结紧急远程航空医疗运送的经验，分析影响空运的多种因素。方法通过2003年5月阿尔及利亚地震灾后，中方5名危重伤员的航空转运的实践，就转运计划、医务人员和医疗设备的配置、空中监护、心理干预等对远程航空医疗运送的作用和影响进行分析和总结。结果 5名危重伤员均安全转运至目的地。结论制订周密的转运计划和进行细致的安排是成功转运的重要条件；灾害伤员的心理干预对安全转运有着特殊意义。     

地震伤员转运救援影响因素分析

目的 分析汶川地震伤员转运医疗救援中的影响因素. 方法 借助第三军医大学附属西南医院院前急救预案配置协调指挥人员、受过心理专业培训的急救专科医护人员和后勤保障人员进行转运伤员以及途中早期施行全程心理疏导. 结果 汶川地震伤员转运救援中,我院救援队员借助院前急救预案、专用器材库支持、整体救援模式和对伤员施行心理疏导,成功转运162例伤员. 结论 本次转运救援模式运行与途中心理救援实践提示,后方医院应建立应对特大灾害伤员心理应激的救援体制,建立健全应对特大灾害远程前接转运救援预案,完善与稳定应对特人灾害批苗伤员远程救援的专业医疗队伍以及建立和完善远程转运的专用医疗物资器材库.     

实施地震伤员大规模航空医疗转运条件的分析

2008年5月12日14:28,我国四川省汶川地区发生了里氏8.0级地震.地震给当地人民的生命财产造成了重大损失,除死亡人数外,受伤人数突破40万,需住院治疗伤员人数超过8万.2008年5月20日至31日,民航共执行航空医疗转运伤员包机99架次,转运伤员3495人,运送伤员家属陪护3168人,随机医护人员941人,分别将伤员运送到广州、深圳、南京等19个医疗条件较好的城市接受治疗,没有伤员在转运途中死亡.笔者通过对我国民航首次大规模航空医疗转运伤员的工作进行回顾和分析,并对今后做好类似工作需完善之处提出建议.     

一批35例烧伤伤员远程转运组织工作的成功经验

目的 总结组织35例烧伤伤员一次性远程转运的成功经验.方法 2006年5月黑龙江某地35例不同程度烧伤伤员,通过航空转运至北京.对转运的组织、指挥工作中的成功经验进行分析、总结.结果 专家医疗组到达后,经20h充分做好转运前准备工作,经4h航空转运,全部伤员均安全、顺利到达接收地.结论 转运前迅速处理危及生命的并发症,稳定伤情,防治继发损伤;制定转运计划,安排转运工具、人员,备齐相关器材、药品,协调出发地、接收地的陆空、空陆衔接,尽量缩短转运时间;任务布置明确,落实确实,责任到人是保证本批伤员长途转运成功实施的关键.     

成批烧伤早期处理中几个问题的探讨

目的：探讨成批烧伤早期救治与航空转运的经验。方法：总结2001—06—23发生在甘肃省某地一批22例成批烧伤伤员的早期救治与航空转运工作。结果：13名伤员分4批次被安全转送至西安、重庆和北京，1名轻伤员留原地治疗，8名伤员死亡。结论：提高基层医院成批烧伤应急水平与改善其基本装备十分必要，建立全国范围的航空救治组织迫在眉睫。     

固定翼飞机多次空运后送重度伤员的救治体会

目的 总结利用固定翼飞机多次空运医疗后送重度伤员的经验,为今后伤员的空运医疗后送提供有益参考.方法 医疗卫生飞机(固定翼飞机)装备我军以来,执行5次空运医疗后送任务,共9名重度伤员,进行回顾性分析和经验总结.结果 9名重度伤员,包括3名重度颅脑损伤、2名骨折、4名重度烧伤伤员,经过转运前精细的评估,充分的准备,周密的组织协调及流程推演,机上严密监护及紧急处理,全部伤员均安全后送至目标医院.结论 空运医疗后送是目前平战时伤员医疗后送的主要方式,可以极大的降低重度伤员的病死率和伤残率.     

严重多发伤的陆地远程转运

危重伤员远程转运包括病情评估、转运前预处理及转运途中处理3个环节。严重多发伤病人陆地远程转运时，在转运前根据病情评估进行预处理，转运途中给予重症监护和专科处理可降低严重创伤病人的转运风险。     

地震灾后急危重伤员跨国远程空中转运的体会

今年5月阿尔及利亚发生强烈地震,造成严重人员伤亡和大量房屋倒塌。我国政府立即决定派出中国国际救援队赴阿尔及利亚实施紧急救援,在圆满完成阿境内的紧急救援行动后,将地震中受伤的我驻阿机构5名急危重伤员．由中国国际救援队实施跨国远程空中医疗转运,护运回国内进行治疗。现将有关情况报告如下。     

严重多发伤的陆地远程转运

危重伤员远程转运包括病情评估、转运前预处理及转运途中处理3个环节.严重多发伤病人陆地远程转运时,在转运前根据病情评估进行预处理,转运途中给予重症监护和专科处理可降低严重创伤病人的转运风险.     

阿尔及利亚地震灾后伤员灾害心理研究及航空运送心理辅助

在我院参加了中国国际救援队的医疗组织以后,参与地震救援工作全面展开。在救援工作中我们发现,受灾人群普遍存在各类心理问题,迫切需要心理专业人才对受灾人群进行必要的心理干预辅导,同时急需建立救援医学心理学体系。2003年5月阿尔及利亚地震后,我院迅速派遣国际救援队医疗队员前往救灾,并成功运送5例伤员回国治疗,由于     

Aeromedical evacuation in the "Luftwaffe" from its origins until 1945

Prior to WWII, Germany had little experience in aeromedical evacuation (AE) of the sick and wounded. The need for a specialized AE organization was recognized, organized, and used extensively on all fronts during WWII. Nearly 2.5 million casualties were transported by regular troop carriers and 11 specialized AE Units, which concentrated on the intensive care air transport of the seriously wounded, especially those with injuries of the brain, eyes, or jaw, thoracic or abdominal wounds, or gun-shot fractures. The AE Units were commanded by medical officers, most of whom were pilot-physicians, who had command jurisdiction over flying and line personnel as well as medical service personnel. The AE Units were equipped with both Junkers Ju-52s, which could carry up to 12 litter patients plus 3 to 5 ambulatory patients each, and with Fieseler Fi -156s (STOL "Stork" for 1 or 2 litter patients), ambulances, as well as the personnel needed for operating and maintaining the vehicles and materiel. The AE Units of the Luftwaffe--the Sanitaetsflugbereitschaften--made an outstanding contribution to military medical care in achieving this significant number of casualties evacuated under the humanitarian symbol of the Red Cross.     

Strategic aeromedical evacuation: the inaugural flight

Strategic aeromedical evacuation, a vital subsystem of the overall aeromedical airlift system, had its beginning in a confidential, poorly planned, poorly coordinated Air Transport Command flight from Karachi, Pakistan (then part of India) to Washington, DC, in January 1943. That the flight was successfully completed was due in large measure to the untiring efforts of the nurse, Second Lieutenant Elsie S. Ott, aboard the flight. Lessons learned in the form of recommendations made by Lt. Ott were implemented to improve succeeding strategic aeromedical evacuation missions. Largely through Lt. Ott's efforts, long range aeromedical evacuation was demonstrated to be a practicable method of transportation for seriously ill and wounded patients. A new dimension had been added to the overall aeromedical airlift mission.     

Flight psychology at Sheppard Air Force Base.

Flight psychology is the application of psychological principles to the unique environment of the aviator in order to enhance training, flight safety, and mission accomplishment. At Sheppard Air Force Base, TX, flight psychology is a cooperative effort between a clinical psychologist and the aeromedical services, with the former acting as a consultant to the latter. The primary focus of the flight psychology program is stress management, including managing the stress response of airsickness, for students in the Euro-NATO Joint Jet Pilot Training (ENJJPT) program. Psychological assessments of flying personnel, air traffic controllers, and individuals being considered for special duties constitute a valuable contribution to aeromedical services. We present clinical vignettes to illustrate the interaction of the flight psychologist and aeromedical services, and the effect on flying training and flight safety.     

Historic aeromedical perspective on left bundle branch block

Military aviators represent a very highly trained, expensive personnel resource. It is incumbent upon the military medical care systems to manage the health aspects of this resource as wisely as possible. This can best be accomplished through a combination of preventive medicine and health promotion oriented clinical care coupled with epidemiologically sound aeromedical standards which ensure that flying safety and mission completion will not be compromised. Epidemiologically sound aeromedical standards, in most cases, can be formulated only through responsible clinical aeromedical research and investigation which is performed within the population for which the aeromedical standards are intended.     

Management control of aeromedical evacuation systems

Aeromedical evacuation has been extensively used by military forces for evacuation of wartime casualties, but has also proven useful in civilian disaster response. In contrast to the broad coverage of the clinical aspects of the aeromedical evacuation, the operational and management control issues have rarely been addressed. The sophisticated battlefield of the 1980s has had an impact also in air evacuation, adding to the factors to be considered before launching an evacuation mission. The professional control of aeromedical evacuation is, therefore, crucial to the efficient and smooth operation of this high-cost resource. In an attempt to shed light on some of the operational perspectives of military air evacuation, the Israeli experience in the management control of such systems is discussed.     

The role of the flight surgeon in Greece

From 1915 [corrected], the first time a flight surgeon participated in an aeromedical evacuation, to the present, the role has become more fundamental by working in wars and operations, experiencing search and rescue aeromedical evacuations from mass accidents or motor accidents, treating seriously ill individuals, and caring for wounded victims of attacks either at the scene or at the hospital. The improvements in cognitive and technological standards of medical science and in the education available have contributed in upgrading the role of flight surgeons; however, their presence in flight is considered essential in 20-60% of aeromedical evacuations, with the remainder of the flights being covered by paramedical personnel. In the Greek territory, the development of Air Force medicine began with the U.S. education of Panagiotis Korombilis, founder of the Center for Flight Crew Health Examination in 1936. In 1976, the Air Force Medical Center was established in the General Air Force Hospital while the educational and medical work of Air Force physicians led to the development of Air Force Medicine and supported Olympic Airways and Military Air Force development, which provides aircraft and personnel for patient aeromedical evacuations. An organized aeromedical evacuation system based on the National Health System, however, began operating in 1982 and was upgraded in 1994. Currently, the flight surgeon's work remains important in supporting the Military Air Force by offering regular examinations at the Air Force Medical Center for all personnel flying on civil and military aircrafts, and by educating all the Greek territory and Cypriot Air Force surgeons (of the National Emergency Assistance Center and the Military Services) at the Air Force Medical Center. Their presence at Air Force bases is important, as is their support of the overall well-being of flight personnel, their assistance in upholding the territory's future by improving aircraft and equipment and by purchasing search-rescue aeromedical evacuation helicopters and hospital aeromedical transportation aircraft capable of transporting seriously ill patients, their promotion of collaboration with other countries in educating Air Force surgeons, and in support of valuable human life according to the Hippocratic Oath.     

Considerations in the aeromedical evacuation of a critically ill blast victim: lessons learned

Rationale for the decision to transport and assessment of available resources are integral components of the decision for aeromedical evacuation of critically ill patients. We present the case of a 20-year-old man who sustained significant trauma after his vehicle struck a land mine. This case reviews and emphasizes the factors to consider in arriving at the decision to transport as well as the accurate assessment of available equipment and personnel resources.     

Physician roles in aeromedical evacuation: current practices in USAF operations

Physicians play an increasingly important role in the critical medical process of aeromedical evacuation (AE). Incomplete or inappropriate preparation for AE can result in increased patient discomfort, and in the worst cases, potentially serious or insurmountable in-flight medical problems. During military operations and in response to natural disasters, physicians are responsible for four processes necessary for a successful AE mission. These include: 1) AE screening, including determination of appropriate classification, precedence, and special medical requirements; 2) validation; 3) medical preparation; and 4) clearance. Physicians responsible for preparing patients for AE need to understand both the patient evacuation system and the unique medical aspects associated with AE. The U.S. military patient evacuation system is comprised of three principal transportation phases: casualty evacuation; inter-theater AE; and intra-theater AE. Important elements of the USAF AE system are patient movement requirements centers, the validating flight surgeon, aeromedical staging facilities, AE liaison teams, aeromedical crews, and critical care air transport (CCAT) teams. Important medical aspects unique to AE include the effects of flight physiology on medical conditions, oxygen limitations, and distinctive medication and supplies requirements.     

A nationwide survey of civilian air ambulance services

To identify and characterize civilian air ambulance services, a questionnaire was mailed nationwide to 583 prospective air ambulance services, with 154 responding. Our survey identified differences between hospital, hospital-affiliated, and private air ambulance services as to aircraft ownership, availability, types of aircraft, types of patients being transported, types of medical personnel and equipment, aircraft retrofit, and their feelings regarding air ambulance regulations. We found that hospital air ambulances are better suited for transporting critically ill patients while many private air ambulances appear better suited to transport nonemergency patients. Hospital-affiliated air ambulance services, although not as consistent in providing the specialized care of hospital air ambulances, appear better able to provide critical care than private air ambulance services. Based upon this data, we recommend that air ambulance regulations be directed at levels of patient care. Such regulations and guidelines will assist patient safety during aeromedical transports without jeopardizing currently operating air ambulance services.     

Air ambulance regulations: a model

Prior attempts at establishing minimal federal air ambulance regulations and standards have been unsuccessful. However, reports of poor patient medical care during transport by some air ambulance services is now forcing many states to initiate air ambulance regulations. In 1984, the State of Utah Emergency Medical Services convened a special subcommittee to develop aeromedical regulations for the State of Utah. Using a three-level approach based upon the patient's requirements for basic, advanced, or specialized medical care and the urgency of transport, the subcommittee was able to derive medical categories necessary for the selection and utilization of air ambulance services. Minimum air ambulance regulations were then established for aircraft configuration, flight crew requirements, minimal equipment and medications, and the responsibilities of the medical director or designee for each of the three levels of medical care. We conclude that the application of a levels approach based upon the patient's medical requirements may be useful in assisting other states attempting to establish flexible but specific regulations directed at the safe transport of patients by aeromedical evacuation.