Transport of a patient with pneumocephalus

["Gary McCormick" <gary@ams.org.za>]

HI Rollie,

We have the pleasure of Rotorwing BO105 and Pressurised Fixedwing (FW) Pilatus PC12.

Our SOP's would normally refer a patient > 250km (±138miles) out by FW Air transport.
In this particular diagnosis, we would certainly prefer the pressurised aeromedical environment especially if there is 9000ft of mountain to get over a likely situation in our case.
If FW not available or no suitable airfield, we would transfer by RW as our mountain ranges have a few passes (possible increased leg time) that we can navigate which would not result in any excessive increase in altitude as apposed to road transport.

Wishing all a safe and joyful season.

Gary Mc Cormick
SA Red Cross Air Mercy Service
P.O. Box 93; Cape Town International Airport; 7525
Emergency No.: 0861 267 267 (SA only)
Tel: (++27) (0) 21 934 0916
Fax: (++27) (0) 21 934 8700
E-mail: gary@ams.org.za
Web site: www.ams.org.za
  ----------------------------------------------------------------------

  Message: 1
  Date: Fri, 19 Dec 2003 11:40:32 -0600
  From: "Alejandro Cabrera, M.D." <spe@prodigy.net.mx>
  Subject: Re: Transport of a patient with pneumocephalus
  To: Flightmed <flightmed@flightweb.com>
  Message-ID: <001801c3c657$4db81570$62de40c8@athlon>
  Content-Type: text/plain; charset=iso-8859-1

  Rollie:
  I think the best controled the best results, so if you have the choice I
  could use the controled cabin.
  The problem in the uncontroled cabin , is that the patients not always are
  going to be 200 or 6000 feet high and as you know everything above 5000 ft.
  will increase the air expansion as "BOYLES LAW" says , and , is not that
  bellow doesn't have the effect but at least in my country the most of the
  times in some  point of the flight the pilot have to go to 9000 ft. and it
  has a deleterious effect in the patient.
  My experience is based in 20 years (1984) and most of my flights are been in
  Cessnas with uncontroled cabin.
  Alejandro Cabrera, M.D.
  ALS ambulances.
  Servicio Privado de Emergencia.
  Guadalajara, Jalisco, MX

  ----- Original Message -----
  From: "Rollie Parrish" <rparrish@flightweb.com>
  To: <flightmed@flightweb.com>
  Sent: Thursday, December 18, 2003 6:06 PM
  Subject: Transport of a patient with pneumocephalus


  > Here's a question for the group, especially those in the Mountain states.
  >
  > I'm trying to determine a "standard of care" for the transport of a
  > patient with documented pneumocephalus.  The main issue is whether or
  > not transport in a pressurized aircraft is warranted, required,
  > preferrable, or just not clinically significant.
  >
  > Supposedly this topic was raised at an AMTC presentation in Reno which
  > lead to a heated debate by the attendees. I don't want to get into a
  > specific scenario, but for the sake of discussion, let's just assume
  > that the patient must be transported 100 miles over a mountain range.
  > The start and ending altitude is 2000 and the max is 6,000.
  >
  > So, what do you think? If you have a patient with a known
  > pneumocephalus, how should they be transported? If it depends on various
  > factors, such as volume, concomittant injuries, vital signs, level of
  > consciousness, please explain. If your program happens to be able to
  choose
  > between pressurized and non-pressurized aircraft, would this diagnosis
  > help influence the mode of transport? Or is this not a
  > clinically significant issue for the most part?
  >
  > Thanks in advance
  > --
  > -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-
  > Rollie Parrish
  > FlightWeb: For Air Medical Professionals
  > http://www.flightweb.com
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