Critical Care Transport Medicine Research Articles

Association of Geographic Distance and Hospital Characteristics With Use of Interhospital Transfer by Air: A Multicenter Retrospective Study

ObjectiveInterhospital transfer by air (IHTA) represents the majority of helicopter air ambulance transports in the United States, but the evaluation of what factors are associated with utilization has been limited. We aimed to assess the association of geographic distance and hospital characteristics (including patient volume) with the use of IHTA. MethodsThis was a multicenter, retrospective study of helicopter flight request data from 2018 provided by a convenience sample of 4 critical care transport medicine programs in 3 US census regions. Nonfederal referring hospitals located in the home state of the associated critical care transport medicine program and within 100 miles of the primary receiving facility in the region were included if complete data were available. We fit a Poisson principal component regression model incorporating geographic distance, the number of emergency department visits, the number of hospital discharges, case mix index, the number of intensive care unit beds, and the number of general beds and tested the association of the variables with helicopter emergency medical services utilization. ResultsA total of 106 referring hospitals were analyzed, 21 of which were hospitals identified as having a consistent request pattern. Using the hospitals with a consistent referral pattern, geographic distance had a significant positive association with flight request volume. Other variables, including emergency department visit volume, were not associated. Overall, the included variables offered poor explanatory power for the observed variation between referring facilities in the use of IHTA (r2 = 0.09). Predicted flights based on the principal component regression model for all referring hospitals suggested the majority of referring hospitals used multiple flight programs. ConclusionGeographic distance is associated with the use of IHTA. Unexpectedly, most basic hospital characteristics are not associated with the use of IHTA, and the degree of variation between referring facilities that is explained by patient volume is limited. The evaluation of nonhospital factors, such as the density and availability of critical care or advanced life support ground emergency medical services resources, is needed.

Management of patients with impella devices or intra-aortic balloon pumps during helicopter air ambulance transport in observational data.

Placement of percutaneous ventricular support devices such as an intraaortic balloon pump (IABP) or Abiomed Impella device can treat severe cardiogenic shock. Critical care transport medicine (CCTM) providers frequently manage patients supported by these devices during interfacility transfers, often using a helicopter air ambulance (HAA). An understanding of patient needs and management during transport is essential to informing crew configuration and training, and this study adds to the limited existing data on the HAA transport of this complex patient population. We performed a retrospective chart review of all HAA transports of patients with an IABP (n = 38) or Impella (n = 11) device at a single CCTM program from 2016 to 2020. We evaluated transport times and composite variables for the frequency of adverse events, condition changes requiring critical care evaluation, and critical care interventions. In this observational cohort, patients with an Impella device more frequently had an advanced airway and at least 1 vasopressor or inotrope active prior to transport. While flight times were similar, CCTM teams remained at referring facilities longer for patients with an Impella device (99 vs 68 minutes; p = 0.0097). Compared to patients with an IABP, patients with an Impella device more frequently had a condition change requiring critical care evaluation (100% vs 42%; p = 0.0005) and more frequently received critical care interventions (100% vs 53%; p = 0.0037). Adverse events were uncommon and did not differ for patients with an Impella device compared to an IABP (27% vs 11%; p = 0.178). Patients requiring mechanical circulatory support with IABP and Impella devices frequently require critical care management during transport. Clinicians should ensure the CCTM team has appropriate staffing, training, and resources to meet the critical care needs of these high acuity patients.

Statin Administration for ST-Elevation Myocardial Infarction During Rotor Wing Transport

ObjectiveThe aim of this study was to evaluate the feasibility of statin administration by a critical care transport medicine (CCTM) team during rotor wing transport for ST-elevation myocardial infarction patients to a percutaneous intervention–capable center. MethodsWe conducted a retrospective study at a single CCTM program after an intervention focused on statin administration for ST-elevation myocardial infarction that included a formulary change and a single brief educational presentation to flight physicians. A comparison group of flight nurse practitioners underwent training after the study period and were used as a control. Two authors completed an independent chart review to collect data. Descriptive statistics and chi-square or Mann-Whitney U testing were used to compare groups. ResultsStatin administration (or documentation of statin administration before CCTM crew arrival or contraindication to statin administration) occurred during 15 of 19 (79%) transports staffed by trained providers and 3 of 18 (17%) transports staffed by untrained providers (P < .001 by chi-square test). Scene times were not significantly different between transports by trained and untrained providers. ConclusionIn summary, we demonstrate the feasibility and safety of a protocol for statin administration in the CCTM setting.

30th Critical Care Transport Medicine Conference

The Perdido Beach Resort in Orange Beach, Alabama has been selected to host the 30th Annual Critical Care Transport Medicine Conference (CCTMC), scheduled for April 11 - 13, 2022. This luxurious, yet family-friendly destination is affordable, and offers the perfect setting to blend business and pleasure.

29th Critical Care Transport Medicine Conference

29th Critical Care Transport Medicine Conference

27th Critical Care Transport Medicine Conference

You won't want to miss the 2019 Critical Care Transport Medicine Conference (CCTMC) April 15-17 at the Hotel Albuquerque at Old Town in Albuquerque, New Mexico. CCTMC is presented by the Air & Surface Transport Nurses Association (ASTNA), the Air Medical Physician Association (AMPA), and the International Association of Flight and Critical Care Paramedics (IAFCCP).

26th Critical Care Transport Medicine Conference

26th Critical Care Transport Medicine Conference

25th Critical Care Transport Medicine Conference

We're heading back to San Antonio—historic, romantic and vibrant. Come discover it for yourself! You won't want to miss the 2017 Critical Care Transport Medicine Conference (CCTMC) April 10-12 at the Wyndham San Antonio Riverwalk in San Antonio, Texas.

23rd Critical Care Transport Medicine Conference Preview

23rd Critical Care Transport Medicine Conference Preview

When Good Isn't Good Enough

The Critical Care Transport Medicine Conference held in Austin, TX, in April 2014 hosted many great speakers. There was a common theme in all the presentations of improving the care we provide to make it both better and safer. Michael Frakes captured my interest with his talk “Eyes On the (Wrong) Prize” (oral communication, April 2014) that examined how and why errors are still present even though everyone has programs, systems, and strategies in place to minimize them. He made a clear and concise argument that although there is much focus on reducing errors, it seems that, despite all of the effort, the same mistakes we made a decade ago are still being made today.

22nd Critical Care Transport Medicine Conference

We're going back to Austin, live music capital of the world®! You won't want to miss the 2014 Critical Care Transport Medicine Conference (CCTMC) March 31 through April 2 at the Sheraton Austin Hotel at the Capitol. CCTMC is presented by the Air & Surface Transport Nurses Association (ASTNA), the Air Medical Physician Association (AMPA), and the International Association of Flight and Critical Care Paramedics (IAFCCP).

21st Critical Care Transport Medicine Conference: We're Going to Austin-Live Music Capital of the World!

You won't want to miss the 2013 Critical Care Transport Medicine Conference (CCTMC) April 8th to the 11th at the Sheraton Austin Hotel at the Capitol. CCTMC is presented by the Air & Surface Transport Nurses Association (ASTNA), the Air Medical Physician Association (AMPA), and the International Association of Flight and Critical Care Paramedics (IAFCCP).

CCTMC Goes Back to Music City for 20th Anniversary

You won't want to miss the 2012 Critical Care Transport Medicine Conference (CCTMC), to be held April 2-4 at the Loews Vanderbilt Hotel in Nashville—a premier critical care transport education opportunity. Join your peers for a spectacular 20th celebration. Find out who has attended every CCTMC and who has presented the most times. Bring photos of past conferences to share with the group.

We're Heading to Music City: 19 th Critical Care Transport Medicine Conference

Nashville is a city that resonates with life and vibrates to the beat of every kind of song. It is a town that sizzles with American music, Southern hospitality, unbelievable cuisine, and a boundless spectrum of nightlife.

2010 Critical Care Transport Medicine Conference Abstracts

The following abstracts are from the poster presentations made at the 2010 Critical Care Transport Medicine Conference held April 12-14, 2010, at the Sheraton Gunter Hotel in San Antonio, Texas. The Scientific Forum is sponsored by the Air Medical Physician Association, Air and Surface Transport Nurses Association, and International Association of Flight Paramedics; the first place winner received an Outstanding Research Award from Golden Hour Data Systems, Inc. For more information, contact Pat Petersen at ppeter1111@aol.com.

18th Critical Care Transport Medicine Conference April 12-14, 2010

Suffering from an acute case of the winter blahs? Leave the snowbanks behind and head south to beautiful San Antonio for a shot of sunshine and fun! The Critical Care Transport Medicine Conference (CCTMC) offers a clinically driven educational opportunity second to none. Join us April 12-14, 2010, at the Sheraton Gunter Hotel, one block from the world-famous River Walk. CCTMC is presented by the Air & Surface Transport Nurses Association (ASTNA), the Air Medical Physician Association (AMPA), and the International Association of Flight Paramedics (IAFP).

Quantifying the Value of AMPA Membership Services

Introduction The purpose of this study was to quantify the value of current and future Air Medical Physician Association (AMPA) membership services. Methods Three-hundred-ninety-eight AMPA members were contacted by e-mail to participate in ranking AMPA membership services by a perceived numeric value (10 = highest to 1 = lowest), using a web-based survey. Results One-hundred-eighteen AMPA members completed the survey. The percentage of respondents having attended the conference and their AMPA-related Conference ranked-value scores were as follows: Air Medical Transport Conference (AMTC), 43%, 9.6 ± 1.9; AirMed International Conference, 9%, 7.8 ± 4.2; AMTC Pre-conference, 65%, 7.6 ± 2.5; Critical Care Transport Medicine Conference (CCTMC), 47%, 6.6 ± 2.6; CCTMC Pre-conference, 37%, 6.6 ± 2.6; the Association of Air Medical Services (AAMS) Mid-Year Conference, 6%, 6.4 ± 4.9; and General Membership meeting, 63%, 5.6 ± 2.4. Current AMPA Benefit/Service ranked-value scores were as follows: textbook, 8.4 ± 1.8; voice for physicians, 8.0 ± 2.3; position papers, 7.9 ± 1.8; Air Medical Journal subscription, 7.8 ± 2.1; networking with others, 7.7 ± 2.4; newsletter, 7.3 ± 1.9; means to enhance professional credibility, 7.1 ± 2.5; web site, 7.0 ± 2.1; voice on Commission on Accreditation of Medical Transport Systems (CAMTS), 7.0 ± 2.7; continuing medical education (CME) credits, 6.6 ± 3.0; conference discounts, 6.4 ± 2.9; and curriculum vitae builder, 4.9 ± 2.9. Future AMPA Benefits/Services ranked-value scores were as follows: evidence-based guidelines, 8.6 ± 1.7; transport database, 7.7 ± 2.1; malpractice repository, 7.6 ± 2.2; DVD lectures, 7.4 ± 2.0; medical director certification, 7.2 ± 2.9; lobbying, 7.1 ± 2.4; photo library, 6.4 ± 2.3; salary and benefits surveys, 6.4 ± 2.6; speaker's bureau, 6.2 ± 2.4; and consulting service list, 6.2 ± 2.4. Conclusion This AMPA survey was useful in prioritizing membership services.

2006 critical care transport medicine conference abstracts

2006 critical care transport medicine conference abstracts

Forum

Forum

Resident training in pediatric critical care transport medicine: a survey of pediatric residency programs.

The Accreditation Council for Graduate Medical Education (ACGME) Program Requirement for Pediatrics includes specific objectives that pediatric residents participate in both the pre-hospital care of acutely ill or injured patients and the stabilization and transport of patients to critical care areas. Previously, residents were often included as the physician component for many pediatric critical care transport teams. Subsequent regionalization of transport services and development of nurse-only transport teams prompted us to determine the current level of resident participation in pediatric critical care transport as well as how individual residency programs were meeting the educational objectives. A questionnaire was mailed to each pediatric residency program listed in the 1996-1997 GME Directory. Information was obtained regarding the size of the hospital and the residency program, the presence of a pediatric critical care transport team, the number of annual transports, and transport team leader. In addition, the use of pediatric residents for transports was ascertained, as well as their specific role, training requirements, and method of evaluation. Data were received from 138 programs for a return rate of 65%. Eighty percent of programs offered a pediatric critical care transport service. Nurse-led teams were used for 51% of NICU and 44% of PICU transports. Of the 82 NICU and 84 PICU teams that used residents, the majority used them as team leaders (60% and 70%; respectively) with only the minority requiring that they be at the PL-3 year or greater. The training and/or certification required for resident participation in transports varied among programs, with 85% requiring completion of a NICU or PICU rotation, and 94% requiring NRP or PALS certification. Programs that did not allow resident participation provided exposure to Transport Medicine by various mechanisms, including lectures and emergency department (ED) rotations. Pediatric resident participation in critical care transport varies widely among pediatric critical care transport teams. The degree to which residents participate in the transport team would appear to have diminished in comparison to previous studies. Transport teams often use other resources, such as nurses, fellows, or attendings, to lead their transport teams. Pediatric resident exposure to and participation in Transport Medicine varies among programs, as do the methods used to prepare residents for their experience.