Critical Care Air Transport Team severe traumatic brain injury short-term outcomes during flight for Operation Iraqi Freedom/Operation Enduring Freedom

Abstract

Air transport personnel must be prepared to provide standard critical care but also care specific to TBIs, including ICP control and management of diabetes insipidus. Although these patients and their potential complications are traditionally managed by neurosurgeons, those providers without neurosurgical backgrounds can be provided this training to help fill a wartime need. This study provides data for the future development of air transport guidelines for validating and clearing flight surgeons.

Outcome and rational management of civilian gunshot injuries to the brain—retrospective analysis of patients treated at the Helsinki University Hospital from 2000 to 2012

“…This strongly suggests that aggressive surgical management of GSWBs significantly improves outcome. Another probably significant factor contributing to the better survival of the military GSWBs described by DuBose et al is the early attention to ICP management and mechanical ventilation [1] and subsequently better implementation of the Brain Trauma Foundation guidelines [2] than in some series of civilian injuries, including ours.…”

“…However, GSWB leads to higher ICP and lower CPP than other mechanisms of brain injury [35], which suggests that salvageable GSWB patients would especially need neurointensive monitoring and care. Considering that the reported mortality rates of GSWB vary from < 10% to > 90% depending on the patients and injuries included in the studies [1, 6, 7, 11, 15, 16, 17, 18, 19, 20, 23, 24, 26, 33, 35], ICU admission of GSWB patients seems indicated since some of these patients survive their injuries. Moreover, in case the GSWB leads to brain death despite therapeutic efforts, many of these patients are potential organ donors and thus admission to the intensive care unit and ventilator treatment is justified even if the prognosis seems poor [5].…”

Peculiarities of aeromedical evacuation of wounded and sick and ways of its improvement based on the experience of anti-terrorist operation and joint forces operation

“…Such trends are characteristic of many military conflicts, they are associated with changes in the nature of injuries, the need for medical evacuation of infectious and other therapeutic diseases, as well as non-combat injuries, which consist mainly of spinal disorders and other musculoskeletal disorders that occur during training or recreation [1,2,7,8,17].…”

Nurses’ responsibilities in the aerospace environment

“…Nursing practice in the mobile pre-and inter-hospital care in fixed and/or rotary wing aircraft requires previous experience in pre-hospital and hospital contexts, for the development of specific skills and abilities, such as: decision making, teamwork, rapid intervention, and evaluation of patients' clinical conditions (1,(5)(6)(7) . In addition, the nurse develops activities related to planning, organization, and provision of resources for comprehensive and safe patient care (1,8) .…”

“…0551 (8) , and scientific publication on the subject is still scarce, mainly in Brazil. It is also important to consider that the aerospace context is a psychologically and physiologically stressful work environment for professionals, depending on the conditions under which the care is performed (6)(7) .…”