The complexities of aeronautical transfer of acutely unwell neurosurgical patients
Tasiou, Anastasia; Tzerefos, Christos; Karagianni, Maria; Tsianaka, Eleni; Jarratt, Mark; Gazioğlu, Nurperi; Peramatzis, Konstantinos; Broekman, Marike Ld; Rodríguez-Hernández, Ana; Ivan, Daniela L; Janssen, Insa K; Karampouga, Maria; Lambrianou, Xanthoula; Mihaylova, Stiliana; Aydin, Ayşegül Esen; Hernandez-Duran, Silvia; Salokorpi, Niina; Rosseau, Gail; Murphy, Mary (2025-02-08)
Tasiou, Anastasia
Tzerefos, Christos
Karagianni, Maria
Tsianaka, Eleni
Jarratt, Mark
Gazioğlu, Nurperi
Peramatzis, Konstantinos
Broekman, Marike Ld
Rodríguez-Hernández, Ana
Ivan, Daniela L
Janssen, Insa K
Karampouga, Maria
Lambrianou, Xanthoula
Mihaylova, Stiliana
Aydin, Ayşegül Esen
Hernandez-Duran, Silvia
Salokorpi, Niina
Rosseau, Gail
Murphy, Mary
Elsevier
08.02.2025
Tasiou, A., Tzerefos, C., Karagianni, M., Tsianaka, E., Jarratt, M., Gazioğlu, N., Peramatzis, K., Broekman, M. Ld., Rodríguez-Hernández, A., Ivan, D. L., Janssen, I. K., Karampouga, M., Lambrianou, X., Mihaylova, S., Aydin, A. E., Hernandez-Duran, S., Salokorpi, N., Rosseau, G., & Murphy, M. (2025). The complexities of aeronautical transfer of acutely unwell neurosurgical patients. World Neurosurgery, 195, 123692. https://doi.org/10.1016/j.wneu.2025.123692.
https://creativecommons.org/licenses/by/4.0/
© 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
© 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202502101541
https://urn.fi/URN:NBN:fi:oulu-202502101541
Tiivistelmä
Abstract
Objective
Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated, or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors that deserve special consideration in the preparation of these patients for transfer.
Methods
We searched all relevant medical literature, military reports, and travel industry documents on transfer of neurosurgical patients. This review was combined with a senior author’s (M.J.) extensive relevant experience, to present important factors for neurosurgeons to consider during planning of aeromedical evacuation, highlighting potential preventable causes of deterioration en route.
Results
Several criteria must be met for a transfer to be considered. The safe transfer of patients with craniospinal pathology requires efficient collaboration between the referring teams, the receiving units/departments, and the medical transfer service. Clear communication, qualified personnel, and appropriate transportation equipment must be available for the transfer. One must consider unique stressors during the air transfer, including the risk of hypoxia on certain types of flights. Vibration, loud noise, acceleration, and changes in barometric pressure en route may negatively affect the patient during transfer. Patient stabilization before transfer is a priority. Medical conditions that can potentially worsen in-flight should be corrected before transfer. The use of a checklist before departure is highly recommended and is included herein. The timing of transfer concerning the postoperative patient deserves special consideration.
Conclusions
Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.
Objective
Neurosurgical care is difficult to access in many scenarios. Aeromedical evacuation of acutely unwell neurosurgical patients from remote, isolated, or poorly equipped locations can be considered. This article aims to provide a framework of logistical factors that deserve special consideration in the preparation of these patients for transfer.
Methods
We searched all relevant medical literature, military reports, and travel industry documents on transfer of neurosurgical patients. This review was combined with a senior author’s (M.J.) extensive relevant experience, to present important factors for neurosurgeons to consider during planning of aeromedical evacuation, highlighting potential preventable causes of deterioration en route.
Results
Several criteria must be met for a transfer to be considered. The safe transfer of patients with craniospinal pathology requires efficient collaboration between the referring teams, the receiving units/departments, and the medical transfer service. Clear communication, qualified personnel, and appropriate transportation equipment must be available for the transfer. One must consider unique stressors during the air transfer, including the risk of hypoxia on certain types of flights. Vibration, loud noise, acceleration, and changes in barometric pressure en route may negatively affect the patient during transfer. Patient stabilization before transfer is a priority. Medical conditions that can potentially worsen in-flight should be corrected before transfer. The use of a checklist before departure is highly recommended and is included herein. The timing of transfer concerning the postoperative patient deserves special consideration.
Conclusions
Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.
Kokoelmat
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