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Activity title

Impact of Aeromedical Evacuation Transport on Patients

Activity Reference

HFM-ET-170

Panel

Human Factors and Medicine

Security Classification

PUBLIC RELEASE

Status

Planning

Activity type

ET

Start date

2018

End date

2019

Keywords

AE, Aeromedical Evacuation, Hypobaria, Hypoxia, Patients, Transport of Patients

Background

Exploratory Topic is proposed to explore the impact of Aeromedical Evacuation (AE) transport on patients. The key features of modern medical centers are replicated in the transport environment (inpatient medical-surgical care, critical care, outpatient and mental health care, and in the future potentially trauma care – damage control resuscitation and surgery). The actual transport environment imposes a number of in-flight stressors, for which the impact on clinical outcomes is not yet fully understood. This ET includes all the stressors of flight but will focus on hypobaria and hypoxia and its impact on the patient physiology and pathophysiology. Additionally, temperature, decreased humidity, biodynamics of vibration and acceleration, and noise, can challenge clinical care during flight and may have significant adverse effects on clinical outcomes. Impacts at the cellular level, cellular metabolism, and vascular epithelium need further research, including discovery of potential countermeasures. Effects on the immune response, and countermeasures, still need considerable discovery research. Effects of the transport environment on provider of care performance need further discovery work to optimize performance of clinical care functions. Specific impact of various organ systems requires additional research; although brain injury has received considerable attention, work remains on the impacts of flight on kidney, liver, cardiovascular system, immune response, and intestinal function. Work remains on the pharmacokinetics of pharmaceuticals used in the transport altitude environment. Engineering solutions to reduce impacts of transport also need to be researched/explored and considered for implementation. Explore topics to see if there are areas of mutual interest for research.

Objectives

The activities of the exploratory team are intended to: i) describe the state of the science regarding the impact of AE transport on patients, specifically related to hypobaria and hypoxia, as well as other stressors of flight. ii) explore the areas of mutual interest among the nations for research and explore mitigating strategies (both engineering, clinical, pharmacologic or non-pharmacologic, aviation/aircraft design, or other relevant strategies). iii) begin development of research strategy to answer questions of mutual interest and to propose more in-depth activities, mainly in the HFM panel and in conjunction with other NATO bodies related to this research area. (iv) set the stage for a future RTG in this topic area

Topics

This ET would explore research topics in all the stressors of flight but will focus on hypobaria and hypoxia and its impact on the patient physiology and pathophysiology. Additionally, temperature, decreased humidity, biodynamics of vibration and acceleration, and noise, that can challenge clinical care during flight and may have significant adverse effects on clinical outcomes. Impacts at the cellular level, cellular metabolism, and vascular epithelium need further research, including discovery of potential countermeasures. Effects on the immune response, and countermeasures, still need considerable discovery research. Effects of the transport environment on provider of care performance need further discovery work to optimize performance of clinical care functions. Specific impact of various organ systems requires additional research; although brain injury has received considerable attention, work remains on the impacts of flight on kidney, liver, cardiovascular system, immune response, and intestinal function. Work remains on the pharmacokinetics of pharmaceuticals used in the transport altitude environment. Engineering solutions to reduce impacts of transport also need to be researched/explored and considered for implementation.

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