Characteristics of patients transported by an aeromedical service for acute toxicologic emergencies: a 5-year experience.
BACKGROUND
Aeromedical services are used routinely in the prehospital and interhospital transfer of patients with trauma, neurosurgical, cardiac, and other conditions requiring specialized care. The use of aeromedical transport in patients with acute toxicologic emergencies is not well described. We sought to investigate and describe the characteristics of patients transported by our aeromedical service.


METHODS
The study was performed at an urban critical care transport service operating both ground and aeromedical units and transporting an average of 3,362 patients per year during the study period.


METHODS
Charts from the 5-year period of 2000 to 2004 for which a toxicologic emergency was coded as the primary diagnosis were identified and reviewed by the authors. Data abstracted included age, sex, toxin(s) involved, treatment rendered at the scene/bedside and en route by the transport team, and additional data (electrocardiogram [ECG] findings, serum levels) when appropriate.


RESULTS
One hundred thirty-three patients were transported (for a total of 135 transports). Most (82%) were transported by air. Carbon monoxide was the most common toxic exposure, accounting for 16% of all transports. Fifty-seven percent of the patients were intubated, with 11% intubated by the flight crew. Antidotes were administered in 40 patients, with naloxone and bicarbonate being the most common.


CONCLUSIONS
Acute toxicologic emergencies accounted for a small percentage of total transports. The most common additional intervention by flight crews was endotracheal intubation. Identification of common poisonings encountered by flight crews may assist services in developing education and quality assurance programs.
Maloney
Gerald E
GE
Department of Emergency Medicine, MetroHealth Medical Center, Cleveland, Ohio 44109, USA. gmaloney@metrohealth.org
Pakiela
John A
JA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D002648:Child; D002675:Child, Preschool; D005260:Female; D015386:Hazardous Substances / Q000506:poisoning*; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009820:Ohio; D012189:Retrospective Studies; D014187:Transportation of Patients
D015386:Hazardous Substances