DISASTER MEDICINE No. 3•2022
Experience Performing Respiratory Support in Victims with Severe Injuries during Air Ambulance Evacuations by Light-Class Helicopter
Potapov V.I. 1, Gumenyuk S.A. 1, Sheptunov G.V. 1, Pisarenko L.V. 1
1 Scientific and Practical Center of Emergency Medical Care of the Department of Health of the City of Moscow, Moscow, Russian Federation
UDC 616.24: 616-001.3:614.883:629.7
Summary. The aim of the study was to determine the optimal types of respiratory support for acute respiratory failure in patients with severe trauma during medical evacuation by light-class helicopters.
Materials and research methods. The materials of the study are the data on the performance of respiratory support in patients with various types of trauma and acute respiratory failure for 2016-2021, contained in the automated information-analytical system “Disaster Medicine of Moscow” of the State Budget Institution “Moscow Territorial Scientific and Practical Center for Disaster Medicine of the Moscow City Health Department”.
When performing the study, historical, statistical and analytical methods were used.
Study results and their analysis. The results of the analysis showed:
– proportion of victims with various traumas received in the emergency situations in Moscow constitutes 31,9% of all sanitary losses in emergencies. Of them 12.9% were in an extremely severe and serious condition, including 1.1% who needed artificial lung ventilation and tracheal intubation;
– severe acute respiratory distress requiring ventilation and tracheal intubation was caused in 49.7% of cases by polytrauma, in 38.4 cases — by isolated trauma, in 8.7 cases — by thermal trauma, and in 3.2% of cases — by combined trauma.
The indications and peculiarities of artificial ventilation with tracheal intubation in patients with various traumas to be medically evacuated by a light-class ambulance helicopter have been determined.
Keywords: air ambulance evacuation, artificial lung ventilation, aviation medical teams, light class helicopters, respiratory support, victims with severe injuries
For citation: Potapov V.I., Gumenyuk S.A., Sheptunov G.V., Pisarenko L.V. Experience Performing Respiratory Support in Victims with Severe Injuries during Air Ambulance Evacuations by Light-Class Helicopter. Meditsina Katastrof = Disaster Medicine. 2022;3:55-59 (In Russ.). https://doi.org/10.33266/2070-1004-2022-3-55-59
- Yershov A.L., Shchurov A.Yu. Artificial Lung Ventilation in the Provision of Emergency Medical Care in the Metropolis of Russia. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2016;2:27–32. https://doi.org/10.24884/2072-6716-2016-17-2-27-32 (In Russ.).
- Yershov A.L. Respiratory Support in Emergency Medical Care: Current State of the Problem and Prospects for Development. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2017;18;4:53–59. https://doi.org/10.24884/2072-6716-2017-18-4-53-59 (In Russ.).
- Gellerfors M., Fevang E., Bäckman A., et al. Pre-Hospital Advanced Airway Management by Anaesthetist and Nurse Anaesthetist Critical Care teams: a Prospective Observational Study of 2028 Pre-Hospital Tracheal intubations. Brit. J. Anaesth. 2018;120;5:1103–1109. doi: 10.1016/j.bja.2017.12.036.
- Yershov A.L. Ensuring the patency of the respiratory tract in acute respiratory failure outside the hospital. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2018;3:62-69. https://doi.org/10.24884/2072-6716-2018-19-3-62-69 (In Russ.).
- Carlson J.N, Colella M.R., Daya M.R. Prehospital Cardiac Arrest Airway Management: An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2022;26;sup1:54-63. doi: 10.1080/10903127.2021.1971349.
- Davydov V.V., Loskutova V.O., Yurlov A.A., Davydova O.V. Methods and Formation of Competence for Respiratory Support in Paramedics of Emergency Medical Care. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2020;19;1:27-34. DOI: 10.24884/2072-6716-2020-21-1-27-34 (In Russ.).
- Vaittinada Ayar P., Benyamina M. Prise En Charge Du Patient Brûlé en Préhospitalier. Première Partie: Cas Général et Inhalation de Fumées. Ann. Burns. Fire. Disasters. 2019;32;1:22-29 (In French).
- Yershov A.L., Miroshnichenko A.G., Boykov A.A., Shchurov A.Yu. The Frequency of Acute Respiratory Failure Detection Among St. Petersburg Ambulance Patients and the Results of Visits to Them. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2018;19;1:48-54. https://doi.org/ 10.24884/2072-6716-2018-19-1-48-54 (In Russ.).
- Xu R., Lian Y., Li W.X. Airway Complications During and after General Anesthesia: A Comparison, Systematic Review and Meta-Analysis of Using Flexible Laryngeal Mask Airways and Endotracheal Tubes. PLoS One. 2016;11:0158137. doi: 10.1371/journal.pone.0158137. eCollection 2016.
- Yershov A.L., Shchurov A.Yu. Analysis of the Use of Ventilators in the Provision of Specialized Emergency Medical Care. Vrach Skoroy Pomoshchi = Emergency Doctor. 2014;7:23-31 (In Russ.).
- Sebastian I., Benny K., Andreas B., et al. Re-Creating Reality: Validation of Fresh Frozen Full Cadaver Airway Training with Videolaryngoscopy and Bougie FIRST Strategy: The BOAH-Course: a Prospective, Observational Study. Observational Study. Scand. J. Trauma Resusc. Emerg. Med. 2022;30;1:18. doi: 10.1186/s13049-022-01006-4.
- Shlyafer S.I. Analysis of Indicators of Emergency Medical Care in Russia. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2019;2:4-13. doi: 10.24884/2072-6716-2019-20-2-4-13 (In Russ.).
- Kozyrev D.V., Khupov M.T. Sanitary Aviation Evacuation with Use of Light Helicopters in Megapolis Environment. Meditsina Katastrof = Disaster Medicine. 2017;1:31-33 (In Russ.).
- Park Cl.L, Grier G.R. Provision of Pre-Hospital Medical Care for Terrorist Attacks. Br. J. Anaesth. 2022;128;2:e85-e89. doi: 10.1016/j.bja.2021.10.023.
- Baranova N.N., Goncharov S.F. Quality Criteria for Medical Evacuation: Substantiation of Assessment and of Practical Use. Meditsina Katastrof = Disaster Medicine. 2019;4:38–42. https://doi.org/10.33266/2070-1004-2019-4-38-42 (In Russ.).
- Kasimov R.R., Makhnovskiy A.I., Zavrazhnov A.A.,et al. Criteria for Choosing the Method of Inter-Hospital Transportation of Patients with Severe Trauma. Skoraya Meditsinskaya Pomoshch’ = Emergency Medical Care. 2021;4;22:12-17. DOI: 10.24884/2072-6716-2021-22-4-12-17 (In Russ.).
- Shapkin Yu.G., Seliverstov P.A. Advantages and Disadvantages of Using Helicopters for Sanitary and Aviation Evacuation of Injured Persons (Literature Review). Mediko-Biologicheskiye i Sotsialno-Psikhologicheskiye Problemy Bezopasnosti v Chrezvychaynykh Situatsiyakh = Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2021;2:70-79. DOI 10.25016/2541-7487-2021-0-2-11-17 (In Russ.).
- Eveson L.J., Nevin W., Cordingley N., et al. Aeromedical Evacuation: Experiences from the UK Military Level 2 Hospital in Bentiu, South Sudan, During Op TRENTON. BMJ Mil. Health. 2021;167;5:316-319. doi: 10.1136/bmjmilitary-2020-001448.
- O’Brien D., Houlberg K., Almond M., et al. Clinical Activity at the UK Military Level 2 Hospital Near Bentiu, South Sudan During Op TRENTON from June 2017 to October 2018. BMJ Mil. Health. 2021;167;5:370-371. doi: 10.1136/bmjmilitary-2020-001454.
- Gumenyuk S.A., Fedotov S.A., Potapov V.I., Sysoev A.Yu. Work experience of the aviation medical teams of the scientific and practical center for emergency medical care of the Department of Healthcare of the City of Moscow in 2015-2019. Biomedical and Socio-Psychological Problems of Safety in Emergency Situations. 2020. No. 4. pp. 60-68. DOI:10.25016/2541-7487-2020-0-4-60-68 (In Russ.).
- Gumenyuk S.A., Fedotov S.A., Potapov V.I., et al. Retrospective Multifactor Analysis of Activity of Aeromedical Teams of Territorial Center for Disaster Medicine of Moscow. Meditsina Katastrof = Disaster Medicine. 2019;1:47-49. DOI: 10.33266/2070-1004-2019-1-47-49 (In Russ.).
- Potapov V.I., Fedotov S.A., Gumenyuk S.A., Tolstykh A.N. Improving the Organization of Medical Assistance to Victims with Injuries as a Result of Crisis and Emergency Situations in Moscow. Dostizheniya Rossiyskoy Travmatologii i Ortopedii = Achievements of Russian Traumatology and Orthopedics. Mater. XI All-Russian. Congress of Traumatologists-Orthopedists. V. 1. St. Petersburg Publ., 2018. P. 70-71 (In Russ.).
- Gumenyuk S.A., Fedotov S.A., Potapov V.I., Sheptunov G.V. Aviation Medical Teams in a Megalopolis: Work Experience, Problems, Prospects. Kafedra Travmatologii I Ortopedii = The Department of Traumatology and Orthopedics. 2018;1;31:5-8 (In Russ.).
The material was received 20.06.22; the article after peer review procedure 13.07.22; the Editorial Board accepted the article for publication 23.09.22