Manish Dhawan1, M C Joshi2, Puja Dudeja3. 1. Senior Advisor (Anesthesiology & Critical Care), Army Hospital (R&R), New Delhi, India. 2. Classified Specialist (Anesthesiology & Critical Care), Command Hospital (Air Force), Bengaluru, India. 3. Director MS (PS), Office of DGMS (Army), New Delhi, India.
Abstract
BACKGROUND: Our hospital began work on formulating its own critical care air transport team (CCATT) and patient transfer unit (PTU) in 2007. A total of 293 patients have been evacuated by air using the various models of the PTU from April 2008 to February 2017. This study has been undertaken to formulate a protocol for activation of CCATT for aeromedical evacuation that best suits our setup keeping in view the availability of electromedical equipment, manpower and aircrafts. METHODS: The study is a cross-sectional study involving patients who were air evacuated between January 2010 to February 2017. Statistical analysis tests were performed to compare and analyze the two scoring systems to find out the sensitivity and specificity of the two scoring systems and to find out the degree of agreement. RESULTS: The data using each scoring system were compared with actual requirement of CCATT based on recommendation of team leader of each CCATT mission and available data of each patient. It was observed that the old scoring system showed poor agreement with kappa coefficient of 0.162. The new scoring system based on modified early warning physiological score showed good agreement with kappa coefficient of 0.895. CONCLUSION: CCATT can be activated by peripheral medical echelons based on objective criteria rather than subjective ones so that optimal use of resources can be carried out not only in peace time but also during mass casualty scenarios such as natural calamities or war.
BACKGROUND: Our hospital began work on formulating its own critical care air transport team (CCATT) and patient transfer unit (PTU) in 2007. A total of 293 patients have been evacuated by air using the various models of the PTU from April 2008 to February 2017. This study has been undertaken to formulate a protocol for activation of CCATT for aeromedical evacuation that best suits our setup keeping in view the availability of electromedical equipment, manpower and aircrafts. METHODS: The study is a cross-sectional study involving patients who were air evacuated between January 2010 to February 2017. Statistical analysis tests were performed to compare and analyze the two scoring systems to find out the sensitivity and specificity of the two scoring systems and to find out the degree of agreement. RESULTS: The data using each scoring system were compared with actual requirement of CCATT based on recommendation of team leader of each CCATT mission and available data of each patient. It was observed that the old scoring system showed poor agreement with kappa coefficient of 0.162. The new scoring system based on modified early warning physiological score showed good agreement with kappa coefficient of 0.895. CONCLUSION: CCATT can be activated by peripheral medical echelons based on objective criteria rather than subjective ones so that optimal use of resources can be carried out not only in peace time but also during mass casualty scenarios such as natural calamities or war.