مجموعهمقاالتانتقالهواييبيماران

- انتقالهواييبيمار�ان :مقالهاول 1

- جنبههايپزشكيپروازدرانتقالهواييبيماران : مقالهدوم 2

- AIR EVACUATIONمقالهسوم 3

ويژگي هاي انتقال با هلي ويژگي هاي انتقال با هلي هوا*ييبيمارا*ن كوپتركوپتر ا*نتقال

هواي*ي ت*ا*ر*يخچه ا*نتقال ب*يماران

انتقال هوايي بيماران

AMT انواع

را مي توان بدو گروه را مي توان بدو گروه AMTAMT بطور كليبطور كليعمده تقسيم نمود :عمده تقسيم نمود :

11** AMTAMT با بال ثابت ) هواپيمابا بال ثابت ) هواپيما((

22**AMTAMT توسط بالگردها )هلي توسط بالگردها )هلي))كوپتركوپتر

ويژگي هاي انتقال با هلي ويژگي هاي انتقال با هلي كوپتركوپتر

سرعتسرعت قابليت دسترسيقابليت دسترسي

محدوده عملياتي محدوده عملياتي اندازه كابين اندازه كابين

ارتعاش ارتعاش سروصدا سروصدا

انتقالهواييبيماران انتقالهواييبيماران

براي براي مناسبمناسب كمپاني كمپاني انتخابانتخابانتقال هواييانتقال هوايي

انتقالهواييبيماران

هواپيماهواپيمامحيط محيط

هوا*ييبيمارا*ن هوا*ييبيمارا*ن ا*نتقالا*نتقال

ا*كسي*ژنا*كسي*ژن

امنيت

از جنبه هوانوردي و از جنبه هوانوردي و فنيفني

از جنبه پزشكياز جنبه پزشكي

استفاده استفاده AMTAMT چه وقت ازچه وقت ازشود ؟شود ؟ ميمي

� امداد

� انتقال بين بيمارستاني فوري

ا*نتقالا*نتقال هوا*ييبيمارا*ن هوا*ييبيمارا*ن

سازيب*يمارب*راي سازيب*يمارب*راي آ*ماده آ*ماده

هواي*يهواي*ي ا*نتقال ا*نتقال

جنبه هاي پزشكي پرواز در انتقال هوايي بيماران

اتمسفر•تركيبات اتمسفر•فشار•درجه حرارت•هيپوكسي•

جنبه هاي پزشكي پرواز در انتقال هوايي بيماران

• تغييرات حجم گازها• رطوبت هوا• شتاب• ارتعاش• صدا

AIR EVACUATION

•Physiological Considerations Of Air EvacuationPhysiological Considerations Of Air Evacuation1-1-Changes In Barometric Pressure Changes In Barometric Pressure 2-Variation In Partial Pressure Of Oxygen 2-Variation In Partial Pressure Of Oxygen with Altitude pressure with Altitude pressure

3- Effect Of Acceleration/Deceleration and 3- Effect Of Acceleration/Deceleration and Angle of Climb/DescentAngle of Climb/Descent 4- Noise, Vibration, humidity , light problems , 4- Noise, Vibration, humidity , light problems , Spase limitationsSpase limitations

Changes in barometric pressure

1-Open Head Injuries 2-Facial Fracturel/Specially

Involving Sinuses 3-Open Eye Injuries 4-Pneumothorax 5-Decompression Sickness 6-Air Emboil 7- GasGangrene

سه راه براي پيشگيري* از عوارض ناشي از تغييرات فشار

بارومتريكيكي حفظ ارتفاع پروازي در نزديكترين نقطه ممكن به

سطح دريا

دوم استفاده از آمبوالنس هوايي داراي كابين هواي فشرده

سوم پيش بيني و تخليه فضاهاي حاوي گاز آزاد تا حد امكان

ت*و*جه مهمت*و*جه مهم

For all patients who require an

aeromedical evacuation a strict altitudelimit of 8000 ft

is mandatory .

10 liter o21 - All patient in the rapid transport

category 2 – Open eye injuries3 -Pacial fracture and / or nosebleed with nasal obstraction 4 -Pneumothorax 5 -Chest injuries

6 - Bowel obstruction7 - Decompression sickness 8 - Air emboil 9 - Patient with respiratory

distress 10 – Chest pain with suspected

heart attack 11 – Strokes , Sizures 12 – Coma 13 – Spinal cord injuries

ANGLE OF ANGLE OF CLIMB /CLIMB /

EFFECT OFEFFECT OFACCELERATION ACCELERATION DECELERATIONDECELERATION

مسائلواسترسورهاسايرپروازيمحيطبامرتبط

1- AIR SICKNESS 2 – NOISE 3 – TURBULANSE 4 – VIBRATION 5 – ELECTRICAL LIGHLING 6 – HUMIDITY 7 – SPACE LIMITATION

Considerations in the scen of accident :

1 - The need for an air evacuation 2 - Aircraft selection 3 - Preflight comunication with flightcrew4 - Preflight comunication with ambulance dispatch and hospital 5 - Checklist prior to aircraft arrival 6 - safty procedures around hellicopter and fixed-wing aircraft 7- pre take-off checklist 8 - Inflight patient monitoring

9 - Backup procedures in the event of equipment failure. Unavailability of aircraft poor weather conditions.

The need for an airThe need for an air

evacuation evacuation

Summary of Emergency Conditions

equiring Rapid Transport to Hospital

Trauma

1- Free fall greater than 20 feet 2- Sever deceleration in a motor vehicle accident. - High speed accident and/or major vehicle damage 3- Broken windshield , bent steering wheel or ther significant damag to passenger compartment - Victim thrown from the vehicle. - One or more occupant killed. - Victim involeved in roll-over type accident. 4- Pedestrain , motorcyclist or bicyclist struck at greater than 30 KPh ( 20 MPh ).

- Sever crash injuries

MECHANISM OF INJURYMECHANISM OF INJURY

ANATOMY OF INJURIES

1-Penetrating injury to the head , neck , chest , abdomen or groin.

2-Two or more proximal long-bone fracture i.e femur , humerus.

3-Flial chest. 4-Extensive facial burns , inhalation injury ,

or burns greater than 10 % body surface area , especially if associated with any other trauma.

5-Amputation of extremity other than toe or fingertip

6-Sever head injury defined as :- Glasgow coma score less than or aqual to 13 .

- Decreasing GCS by 2 or more .- Pupillary inequality greater than 1 mm and slugish

response to light . - Extrmity weakness or paralysis , regardless of GCS

, - - depressed skull fracture

7- Spinal cord injury , paraplegia or quadriplegia .

ANATOMY OF INJURIES

1-Parcial or complete airway obstruction. 2-Decreased level of consciousness (GCS<or = 13 ) 3-Raspiratory rate ( less than 10 or greater than 30

per minute ) or sevsr dyspnea . 4-Absent radial pulses . 5-Obvious circulatory shock .

PRIMARY SURVEY

OTHER CONDITIONS

• 1- Chest Injiry With Shortness Of Breath

• 2-Smoke Or Toxic Gas Inhalation , Carbon Monoxid Poisoning

• 3-Decompression Sickness • 4-Air Embolism • 5-Penetrating Eye Injuries

• 6-Modereate Or Sever Hypotheremia • 7-Near Drowning • 8-Major Open Limb Fractures • 9-Electerical Injuries With Burn Grater

Than 10% Of Body Surface Area

OTHER CONDITIONS

MEDICAL EMERGENCIES

1-Cardiac Arrest 2-Coma ( GCS 8 OR LESS ) 3-Acute Poisoning With Any Of The Following - Partialy Or Completely Obstracted Airway - RR < 10 Or Greater Than 30 - Absent Radial Pulses - Altered Mental Status Or Decreased Level Of Consciousness - If So Directed By Poison Control Center

4 -Status Epilepticus 5- Stroke 6-Heart Failure 7- Sever Shortness Of Breath 8- Shock 9- Chest Pain With Suspected Attack 10- Suspected Acute

MEDICAL EMERGENCIES

Flight Medical

Coordinator

Aircraft Selection

Preflight Preflight Communication Communication WithWith Fligh Fligh Crew Crew

Preflight CommunicationPreflight Communication

with with AmbulanceDispatch AmbulanceDispatch

and Hospital and Hospital

Checklist prior

to aircraft

arrival

Safty Procedures

around hellicopter and

fixed-wing

Pre take – off

checklist

Inflight Inflight patientpatient

monitoringmonitoring

Checklist

After Transport