question

["Ann Chandler" <alc24@acsu.buffalo.edu>]

Hello!

    I am a nursing student at the University at Buffalo in New York State. I
have been on this listserv observing and reading the emails sent for the
past few weeks. I am very interested in the field of "Flight Medicine," and
have tossed around the idea of becoming a flight nurse later in my life.
Through my interest and my research I have a question to ask. "Through your
experience and knowledge, does the altitude at which a critically ill client
is transported cause any significant symptoms or problems related to hypoxia
or respiratory distress that may not have occurred if that client were to be
transported on the ground? If so, are there any methods that your agency
uses to ensure that these symptoms do not occur, such as placing that client
on a ventilatory system during the air lift?"

    In reading through a good reference that describes a few case studies
that were performed on animals related to this subject [Chang, Deh-Ming MD.
(2001) Intensive care air transport: The sky is the limit; or is it?
Critical Care Medicine Journal. 29 (11)], I found that "Although the Fio2
remains constant at 21%, the partial pressure of oxygen in ambient air
declines progressively in proportion to barometric pressure as altitude
increases... A patient who requires 70% oxygen at sea level will require 97%
oxygen at 8000 feet above sea level to maintain the same inspired oxygen
partial pressure." (Chang, pp 2228) I also found that as altitude increases
there is typically a reduction in the lung's forced vital capacity as well
as an increase in residual volume. Therefore it can be stated that by
increasing the altitude at which a client is transported can lead to a
higher chance of acquiring a secondary condition during the air lift.  I
would love to hear of any experiences and comments that you may have related
to my initial question!

    Thank you very much for you input on this subject, I truly am interested
in your responses!

Ann L. Chandler
Student Nurse
Class 2003
University at Buffalo
alc24@acsu.buffalo.edu



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