Occupational injuries and stressors among Canadian air medical health care professionals in rotor-wing programs

INTRODUCTION: Air medical health care providers work in a unique environment that may affect occupational injury rates and patterns. Despite this knowledge, little high-quality evidence exists regarding occupational injuries specifically incurred by air medical health care professionals. We sought to characterize the epidemiology of occupational injuries experienced by Canadian rotor-wing health care providers. METHODS: A survey was sent to the 4 rotor-wing programs in Canada. All crewmembers participating directly in patient care were asked to complete the survey detailing any acute occupational injuries sustained within the previous year. A series of both open- and closed-ended questions was used to collect participant demographics and information regarding any injuries sustained. RESULTS: One hundred and six (40.6%) participants completed the survey. Three hundred and thirty acute injuries were reported. Hand lacerations and leg contusions were most prevalent (31 and 24 individuals incurred these injuries, respectively). Acute back injuries were also prevalent with 25 (23.6%) participants reporting at least one back injury. Overall, an injury rate of 3.2 injuries per person per year was reported. Lifting was cited as a common factor in injury (30 cases). Most injuries required little treatment, with only 17 needing physician intervention, and only 6 required more than 1 week off work. CONCLUSION: Injuries among Canadian air medical crews are common, but fortunately, the majority are minor. Specific injury prevention strategies may focus on stretcher design, cabin ergonomics, and extremity protective equipment.     

Concerns for medical radiation programs in Australian universities

The Australian higher education system is in a state of great change. The Federal education minister, Dr Brendan Nelson, has indicated that he intends to continue introducing far-reaching reforms that will impact significantly on how universities conduct teaching and research. The future allocation of government funding for university programs, including those in medical radiation, will have a significant effect on how those programs are delivered and could even determine whether programs remain viable. There will be a financial imperative for academic departments to strengthen research activity and to obtain funding from non-government sources, such as full-fee paying students, in order to generate enough income to cover program delivery. Medical radiation education in Australia is also facing many other challenges. Some of these are longstanding, such as the high cost of medical radiation program delivery, poor levels of research activity and difficulty in recruiting and retaining academic staff. Other problems have arisen recently, such as increased competition for students and a critical shortage of available training placements in clinical practice. The aim of this paper is to raise and explore these issues from a university perspective.     

Statewide air medical transports for Massachusetts

In 1997, the Massachusetts Department of Public Health (MDPH) established a process to centralize air medical transport information. This database is one of the first statewide, population-based sources for civilian rotary-wing air medical transports (U.S. Coast Guard, police, and military missions are not included). The purpose of this database is to facilitate MDPH review of air medical transport service utilization, with input from a multidisciplinary committee. This article discusses the challenges in producing uniform data from multiple service submissions and presents aggregate "baseline" utilization information for 1996. These data served as a starting point for later studies using data linkage. This indexed article is the first to report statewide, population-based data for all types of air medical helicopter transports. The only other indexed "statewide air medical transport" paper focused on scene transports to trauma centers in Pennsylvania. A previous article by the authors in the July-September 2000 Air Medical Journal provided an overview of air medical transports for fatal motor vehicle crashes for 1 region of the state.     

Different educational programs on medical ultrasound examination for radiological technologists and medical technologists

Radiological technologists (RTs) and medical technologists (MTs) are legally allowed to work as sonographers performing medical ultrasound examination. Despite the total number, much fewer RTs work as sonographers than MTs. To explore the reason, we investigated educational programs, universities, and colleges for both specialties. First, we established five categories of sonographers' competency: 1) Anatomy for imaging diagnosis, 2) Diseases and diagnosis, 3) Imaging, 4) Structure and principle of the equipment, and 5) Evaluation of image quality, using competence reported by the International Society of Radiographers and Radiological Technologists (ISRRT) and diagnostic competency required of sonographers in Japan. Using these categories, we analyzed the content and total instruction time by lectures and seminars based on information written in the syllabi, and explored the differences in education related to sonographers' competency in both programs. "Anatomy for imaging diagnosis" was taught in 15 RT programs (93.8%), and 6 MT programs (31.6%). "Diseases and diagnosis" was taught in 13 RT programs (86.7%), and 8 MT programs (53.3%). "Imaging" was taught in 14 RT programs (100%), and 13 MT programs (76.5%). "Structure and principle of the equipment" was taught in 12 RT programs (85.7%), and 6 MT programs (31.6%). "Evaluation of image quality" was taught in 11 RT programs (84.6%), and 3 MT programs (15.0%). The average instruction time for RT was longer than for MT programs in all categories. RTs are educated and have a foundation to be sonographers at graduation, and may have the possibility to expand their career in this field.     

Non-experimental studies in air medical research

This article is the 17th in a multipart series designed to assist readers, particularly novices, in the area of clinical research. This article is focused on the process of developing a new research project. It provides tools to help those involved in beginning their own research projects.     

Experimental studies in air medical research

This article is the 18th in a multipart series designed to assist readers, particularly novices, in the area of clinical research. This article is focused on the process of developing a new research project. It provides tools to help those involved in beginning their own research projects.     

Inverse intubation in air medical transport

INTRODUCTION: The purpose of this study was to investigate the speed and accuracy of the inverse intubation procedure. TECHNIQUE: The operator crouches or kneels over the patient, straddling the torso. The laryngoscope is held in the operator's right hand in an overhand fashion, inserted gently into the patient's mouth, and pulled up and caudad. When the vocal cords are visualized, the endotracheal tube is passed with the left hand. METHODS: The procedure was taught to flight nurses and respiratory therapists (n = 21) using an intubating mannequin strapped to a stretcher in a BK 117 helicopter to simulate an in-flight intubation. The subjects were timed intubating the mannequin using both inverse and standard intubation techniques. Each technique was performed twice, and the times were averaged. The Wilcoxon Signed Ranks test was used to determine statistical significance. RESULTS: No significant difference occurred between times of the standard (24.0 s) and inverse techniques (21.6 s) (P =.715) or number of attempts for successful endotracheal intubation (1.12 and 1.07, P =.581). CONCLUSION: Inverse intubation is a useful skill for prehospital providers. This skill can be taught in a brief period and used successfully with no compromise in speed or success rate.