Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation

William P. Butler, Lawrence W. Steinkraus, Esther E. Burlingame, Danny E. Smith, Brittany L. Fouts, Jennifer L. Serres, David S. Burch

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Combat medical care relies on aeromedical evacuation (AE). Vital to AE is the validating flight surgeon (VFS) who warrants a patient is "fit to fly." To do this, the VFS considers clinical characteristics and inflight physiological stressors, often prescribing specific interventions such as a cabin altitude restriction (CAR). Unfortunately, limited information is available regarding the clinical consequences of a CAR. Consequently, a dual case-control study (CAR patients versus non-CAR patients and non-CAR patients flown with a CAR versus non-CAR patients) was executed. Data on 1,114 patients were obtained from TRANSCOM Regulating and Command and Control Evacuation System and Landstuhl Regional Medical Center trauma database (January 2007 to February 2008). Demographic and clinical factors essentially showed no difference between groups; however, CAR patients appeared more severely injured than non-CAR patients. Despite being sicker, CAR patients had similar clinical outcomes when compared with non-CAR patients. In contrast, despite an equivocal severity picture, the non-CAR patients flown with a CAR had superior clinical outcomes when compared with non-CAR patients. It appeared that the CAR prescription normalized severely injured to moderately injured and brought moderately injured into a less morbid state. These results suggest that CAR should be seriously considered when evacuating seriously ill/injured patients.

Original languageEnglish (US)
Pages (from-to)193-202
Number of pages10
JournalMilitary Medicine
Volume183
DOIs
StatePublished - Mar 1 2018

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Trauma Centers
Prescriptions
Case-Control Studies
Demography
Databases
Surgeons

Keywords

  • aeromedical evacuation
  • cabin altitude restriction
  • en route care
  • tissue oxygen delivery
  • Validating flight surgeon

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Butler, W. P., Steinkraus, L. W., Burlingame, E. E., Smith, D. E., Fouts, B. L., Serres, J. L., & Burch, D. S. (2018). Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation. Military Medicine, 183, 193-202. https://doi.org/10.1093/milmed/usx171

Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation. / Butler, William P.; Steinkraus, Lawrence W.; Burlingame, Esther E.; Smith, Danny E.; Fouts, Brittany L.; Serres, Jennifer L.; Burch, David S.

In: Military Medicine, Vol. 183, 01.03.2018, p. 193-202.

Research output: Contribution to journalArticle

Butler, WP, Steinkraus, LW, Burlingame, EE, Smith, DE, Fouts, BL, Serres, JL & Burch, DS 2018, 'Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation', Military Medicine, vol. 183, pp. 193-202. https://doi.org/10.1093/milmed/usx171
Butler WP, Steinkraus LW, Burlingame EE, Smith DE, Fouts BL, Serres JL et al. Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation. Military Medicine. 2018 Mar 1;183:193-202. https://doi.org/10.1093/milmed/usx171
Butler, William P. ; Steinkraus, Lawrence W. ; Burlingame, Esther E. ; Smith, Danny E. ; Fouts, Brittany L. ; Serres, Jennifer L. ; Burch, David S. / Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation. In: Military Medicine. 2018 ; Vol. 183. pp. 193-202.
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