No abstract available.
Aircraft* ; Transportation*

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.
Aerospace Medicine ; Air Ambulances ; Aircraft ; Airports ; Chronic Disease ; Critical Illness ; Curriculum ; Defibrillators ; Economic Development ; Emergencies ; First Aid ; Humans ; Korea ; Transportation

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.
Aerospace Medicine ; Air Ambulances ; Aircraft ; Airports ; Chronic Disease ; Critical Illness ; Curriculum ; Defibrillators ; Economic Development ; Emergencies ; First Aid ; Humans ; Korea ; Transportation

Recent evidence has demonstrated the survival benefits of helicopter transport for trauma patients. The purpose of this study was to evaluate the effectiveness of hospital-based helicopter emergency medical services (H-HEMS) in comparison with ground ambulance transport in improving mortality outcomes in patients with major trauma. Study participants were divided into 2 groups according to type of transport to the trauma center; that is, either via ground emergency medical services (GEMS) or via H-HEMS. The study was conducted from October 2013 to July 2015. Mortality outcomes in the H-HEMS group were compared with those in the GEMS group by using the Trauma and Injury Severity Score (TRISS) analysis. The number of participants finally included in the study was 312. Among these patients, 63 were adult major trauma patients transported via H-HEMS, and 47.6% were involved in traffic accidents. For interhospital transport, the Z and W statistics revealed significantly higher scores in the H-HEMS group than in the GEMS group (Z statistic, 2.02 vs. 1.16; P = 0.043 vs. 0.246; W statistic, 8.87 vs. 2.85), and 6.02 more patients could be saved per 100 patients when H-HEMS was used for transportation. TRISS analysis revealed that the use of H-HEMS for transporting adult major trauma patients was associated with significantly improved survival compared to the use of GEMS.
Accidents, Traffic ; Adult ; Air Ambulances ; Aircraft* ; Ambulances ; Emergencies* ; Emergency Medical Services* ; Humans ; Injury Severity Score ; Mortality* ; Transportation ; Trauma Centers ; Wounds and Injuries

No abstract available.
Aircraft* ; Emergencies* ; Transportation*

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.
Acute Coronary Syndrome ; Air Ambulances ; Aircraft* ; Classification ; Cohort Studies ; Diagnosis ; Emergencies* ; Emergency Medical Services* ; Humans ; Intensive Care Units ; Islands ; Korea ; Missions and Missionaries ; Prospective Studies ; Rural Health Services ; Stroke ; Transportation

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.
Acute Coronary Syndrome ; Air Ambulances ; Aircraft* ; Classification ; Cohort Studies ; Diagnosis ; Emergencies* ; Emergency Medical Services* ; Humans ; Intensive Care Units ; Islands ; Korea ; Missions and Missionaries ; Prospective Studies ; Rural Health Services ; Stroke ; Transportation

PURPOSE: The author's trauma center implemented Mobile Trauma Units (MTU), which are ground transportation automobiles constructed with advanced medical equipment, in an attempt to improve the survival rate of severe trauma patients. The purpose of this study was to examine the efficacy of MTU as a means of inter-hospital transfer of patients in urban environments. METHODS: Patients with an injury severity score (ISS) of 16 or more were enrolled in this study. The participants must also be patients who were transferred with the MTU in the 18 months between January 2017 and June 2018. To assess the survival probability, the revised trauma score (RTS), trauma and injury severity score (TRISS), and w-score were used as the outcome indices. RESULTS: Forty-four (86.3%) of the severe trauma patients with an ISS of 16 or more were male and 7 (13.7%) were female. The number of patients from the territory were 32 (62.7%), and patients from the others were 19 (37.3%). All the patients received their injury from blunt force trauma. The average time of from the scene of the accident to the trauma center was 176 minutes. In 13 deaths, 10 (76.9%) of the RTS values were below 4 points. Among the 51 patients, TRISS was more than 0.5 in 32 patients (62.7%). The w-score was 13.25 and the actual survival rate of a patient was 74.50%. CONCLUSION: Ground transportation automobiles that use MTU for severe trauma patients in urban areas are more economically beneficial and more efficient. The survival rate while using MTU was also shown to be higher than that of medical helicopter transfers.
Aircraft ; Automobiles ; Emergency Treatment ; Female ; Humans ; Injury Severity Score ; Male ; Survival Rate ; Transportation ; Transportation of Patients ; Trauma Centers ; Wounds and Injuries

BACKGROUND: Extracorporeal life support (ECLS) is an effective life-saving tool for patients in refractory cardiac or respiratory failure. Although transportation of patients on ECLS is challenging, it is necessary in some instances. We report our initial experience of transporting patients on ECLS. METHODS: The study period was between January 2004 and August 2013. We reviewed our ECLS database and identified four patients who were transported to our institution on ECLS. We excluded patients who were not transported by our ECLS team. RESULTS: There were no clinically significant events during transportation. ECLS indications included acute respiratory distress syndrome in two patients, stress-induced cardiomyopathy induced by pneumonia sepsis in one patient, and cardiac arrest caused by amyloid cardiomyopathy in another patient. One patient was transported by helicopter and three patients were transported in an oversized ambulance. Three patients were successfully weaned off ECLS and discharged without significant complications. CONCLUSIONS: Inter-hospital transport can be safely performed by an experienced ECLS team. Successful transport may improve patient outcome and the ECLS programs of both referring and referral hospitals.
Aircraft ; Ambulances ; Amyloid ; Cardiomyopathies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Pneumonia ; Referral and Consultation ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Sepsis ; Transportation ; Transportation of Patients*

Multiple variables can influence triage decision in multiple trauma. Recognition of priorities and selection of the destination can be successfully achieved by field triage and individualized clinical judgment. This narrative review summarizes the new options and protocols for transport of injured subjects. There are four levels of emergency medical providers including first responders and three levels of emergency medical technicians. Two distinct accepted protocols for transport are known as scoop and run and treat and then transfer. The former provides minimum lifesaving treatment at the scene of accident followed by transferring the patient(s) as soon as possible, and the latter mainly emphasizes the need for complete stabilization as a prerequisite for safe transport. The destination and mode of transport are selected according to clinical capabilities of the receiving hospital, transfer time from the scene to the facility, patient's medical condition, accessibility of the scene, and weather. Two common methods of transfer are ground transport, including various type of ambulances, and air medical transport, i.e. helicopter and airplane.
Air Ambulances ; Decision Making ; Humans ; Mass Casualty Incidents ; Multiple Trauma ; therapy ; Transportation of Patients ; organization & administration ; Triage