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Aeromedical Evacuation of Cardiothoracic Casualties

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Abstract

Cardiothoracic trauma carries a high mortality rate and often requires emergency surgery for survival. Injuries to the lungs and heart can result in massive blood loss and often require surgical treatment. These patients present unique challenges in their care, both before and after surgery. Elective aeromedical evacuation (AE) should be delayed until the patient is well into the convalescent phase of recovery. Urgent AE can be undertaken within hours of most thoracotomies, but such patients require the expertise and equipment of a Critical Care Air Transport Team (CCATT) in most cases. This chapter will address common cardiothoracic injuries, their sequelae, and management during elective and urgent AE.

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References

  1. Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49:496–504.

    Article  CAS  PubMed  Google Scholar 

  2. Cannon JW, Zonies DH, Benfield RJ, Elster EA, Wanek SM. Advanced en-route critical care during combat operations. Bull Am Coll Surg. 2011;96:21–9.

    PubMed  Google Scholar 

  3. Neff LP, Cannon JW, Stewart IJ, Batchinsky AI, Zonies DH, Pamplin JC, Chung KK. Extracorporeal organ support following trauma: the dawn of a new era in combat casualty critical care. J Trauma Acute Care Surg. 2013;75(2):S120–9.

    Article  PubMed  Google Scholar 

  4. McElnay PJ, Lim E. Modern techniques to insert chest drains. Thorac Surg Clin. 2017;27(1):29–34.

    Article  PubMed  Google Scholar 

  5. McBeth PB, Savage SA. Tube thoracostomy. Atlas Oral Maxillofac Surg Clin North Am. 2015;23(2):151–7.

    Article  PubMed  Google Scholar 

  6. Department of the Air Force. Air Force Instruction 10-2909. Aeromedical Equipment Standards. Washington, DC: US Government Printing Office; 2013.

    Google Scholar 

  7. Kwiatt M, Tarbox A, Seamon MJ, Swaroop M, Cipolla J, Allen C, et al. Thoracostomy tubes: a comprehensive review of complications and related topics. Int J Crit Illn Inj Sci. 2014;4(2):143–55.

    PubMed  PubMed Central  Google Scholar 

  8. Bendrick GA, Nicolas DK, Krause BA, Castillo CY. Inflight oxygen desaturation decrements in aeromedical evacuation patients. Aviat Space Environ Med. 1995;66:40–4.

    CAS  PubMed  Google Scholar 

  9. Henry JN, Krenis LJ, Cutting RT. Hypoxemia during aeromedical evacuation. Surg Gynecol Obstet. 1973;136:49–53.

    CAS  PubMed  Google Scholar 

  10. Baron ED, Epperson M, Hoyt DB, Fortlage D, Rosen P. Prehospital needle aspiration and tube thoracostomy in trauma victims: a six year experience with aeromedical crews. J Emerg Med. 1995;13:155–63.

    Article  Google Scholar 

  11. Heffner JE, Brown LK, Barbieri CA. Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Chest. 1997;111:970–80.

    Article  CAS  PubMed  Google Scholar 

  12. Guzman Rojas P, Agostinho J, Hanna R, Karasik O. Spontaneous pneumomediastinum as a consequence of severe vomiting in diabetic ketoacidosis. Cureus. 2018;10(5):e2562.

    PubMed  PubMed Central  Google Scholar 

  13. Cowley RA, Turney SZ, Hankins JR, Rodriguez A, Attar S, Shankar BS. Rupture of the thoracic aorta caused by blunt trauma. A fifteen year experience. J Thorac Cardiovasc Surg. 1990;100:652–61.

    CAS  PubMed  Google Scholar 

  14. Madden MR, Paull DE, Finkelstein JL, Goodwin CW, Marzulli V, Yurt RW, Shires GT. Occult diaphragmatic injury from stab wounds to the lower chest and abdomen. J Trauma. 1989 Mar;29(3):292–8.

    Article  CAS  PubMed  Google Scholar 

  15. Brooks JW. Blunt traumatic rupture of the diaphragm. Br J Surg. 1978;26:199–204.

    CAS  Google Scholar 

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Correspondence to Michael J. Eppinger .

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Eppinger, M.J., Stephens, K.E. (2019). Aeromedical Evacuation of Cardiothoracic Casualties. In: Hurd, W., Beninati, W. (eds) Aeromedical Evacuation. Springer, Cham. https://doi.org/10.1007/978-3-030-15903-0_16

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  • DOI: https://doi.org/10.1007/978-3-030-15903-0_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15902-3

  • Online ISBN: 978-3-030-15903-0

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