Briefly discuss the problems specific to aeromedical transport of a critically ill patient.

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College Answer

a) Transport by any means involves risk to staff and patients 
b) Need to be familiar with the use of the transport vehicle~s 02~ suction, 
communications,and other equipment systems. 
c) Reduction in partial pressure of oxygen with altitude, critically ill patients who 
are already dependent on high Fi02 may be further compromised. 
d) Expansion of trapped gases-pneumothoraces~ intracranial air from injuries 
e) Expansion of air containing equipment - ET tube~ Sengstaken tube. ET cuff 
pressures will need to be adjusted 
f) IABP difficult to transport 
g) Risk of hypothermia 
h) As water partial pressure falls~ risk of dehydration through resp losses and 
passive humidification important 
i) Auscultation is difficult 
j) The ventilated patient is placed in the Trendelenburg and the reverse 
Trendelenburg positions during take off and landing respectively. This can 
impact on perfusion and oxygenation. 
k) Potential for pacemaker malfunction due to avionic interference. 
I) Staff doing air transport should refrain :from compressed. gas diving for at least 24 
hrs prior to transfer. . 
m) Physical problems: col~ noise, lighting, access to patient, motion sickness, 
acceleration injuries ( eg head to front of plane to avoid increased ICP on takeoff

Discussion

This question closely resembles Question 7 from the second paper of 2010.