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 language | English (US) |
|---|---|
| Pages (from-to) | 193-202 |
| Number of pages | 10 |
| Journal | Military Medicine |
| Volume | 183 |
| DOIs | |
| State | Published - Mar 1 2018 |
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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
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 journal › Article
}
TY - JOUR
T1 - Clinical Impact of Cabin Altitude Restriction Following Aeromedical Evacuation
AU - Butler, William P.
AU - Steinkraus, Lawrence W.
AU - Burlingame, Esther E.
AU - Smith, Danny E.
AU - Fouts, Brittany L.
AU - Serres, Jennifer L.
AU - Burch, David S.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - 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.
AB - 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.
KW - aeromedical evacuation
KW - cabin altitude restriction
KW - en route care
KW - tissue oxygen delivery
KW - Validating flight surgeon
UR - http://www.scopus.com/inward/record.url?scp=85045442793&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045442793&partnerID=8YFLogxK
U2 - 10.1093/milmed/usx171
DO - 10.1093/milmed/usx171
M3 - Article
VL - 183
SP - 193
EP - 202
JO - Military Medicine
JF - Military Medicine
SN - 0026-4075
ER -