توجهات انتقال هوایی نوزادان ترومایی

Introduction: Due to the large number of accidents in Iran, infants need the rapid transport to the hospitals. Air transport is the fastest way to arrive these centers. There are differences in trauma management between infants and adults because of their different physiology and anatomy. This study aimed to survey air transport of traumatic infants. Methods and Materials: This research is a review article that has been performed by searching related keywords in various data bases such as Science Direct, Google Scholar, PubMed and SID and 2 relevant books in this field. Results: The main medical care issues for infants air transport include: height, pressure, motion effects, sound and vibration, extubation and air leakage in the lung. At high altitude, O2 requirement increases, while relative pressure of oxygen decreases. Thus, babies are at risk of hypoxia. To prevent rapid diffusion of gases which increases the risk of pneumothorax and air embolism, taking off and landing should be slow. Increasing atmospheric pressure causes the gases to expand and these trapped gases cause Necrotizing Enterocolitis (NEC) and intestinal obstruction. Therefore, Nasogastic Tube (NGT) must be embedded. Thoracentesis may be necessary to reduce air pressure. Pacifier should be used to equalize the pressure in the Eustachian tube during the landing. Ear protection should be used to minimize hearing damage. Matters should be used to minimize vibrations in the incubator and blindfolds used to reduce visual damage. The spine should be kept immobilized and the heating devices used to prevent hypothermia. In addition, Neonatal transmission teams should consist of a neonatologist, neonatal nurses and clinical guides certified and qualified in the field of neonate. Discussion and Conclusion: Due to the fact that infants are the most vulnerable groups, special care is needed during the airlift. Regarding the lack of research on traumatic infants air transport in Iran, it seems to need more research in this area. References 1. Soreide K.. Epidemiology of major trauma. Br J Surg 2009;96(7):697-8. 2. Essebag V, et al. Air medical transport of cardiac patients. Chest 2003;19:37-45. 3. Phillips M, et al, Helicopter transport effectiveness of patients for primary percutaneous coronary intervention. Air Med J 2013;32(3):144-52. 4. Gearhart PA, Wuerz R, Localio AR. Cost-effectiveness analysis of helicopter EMS for trauma patients. Ann Emerg Med  1997;30(4):500-6. 5. Moghadam DA. Air medical transport. 2016; Available at:  http://www.isem.ir/find.php?item=1.119.44.fa 6. Medical aspects of transportation aboard commercial aircraft. JAMA 1982;247(7):1007-11. 7. Khurana  H, Mehta Y, Dubey S. Air medical transportation in India: Our experience. J Anaesthesiol Clin Pharmacol  2016;32(3):359-63. 8. Teitel D, Rudolph A. Perinatal oxygen delivery and cardiac function. Advances in pediatrics 1984;32:321-47. 9. Verklan M, Terese, Walden M. Core curriculum for neonatal intensive care nursing. Elsevier Health Sciences. 2014.‏ 10. Fenton  A, A. Leslie, Skeoch C. Optimising neonatal transfer. Archives of Disease in Childhood-Fetal and Neonatal Edition 2004;89(3):215-9. 11. Gajendragadkar G, et al. Mechanical vibration in neonatal transport: a randomized study of different mattresses. Journal of Perinatology 2000;20(5). 12. Bowman E, Roy R. Control of temperature during newborn transport: an old problem with new difficulties. Journal of paediatrics and child health 1997;33(5):398-401. 13. L'Herault J, Petroff  L, Jeffrey DJ. The effectiveness of a thermal mattress in stabilizing and maintaining body temperature during the transport of very low (ndash) birth weight newborns. Applied Nursing Research 2001;14(4):210-9. 14. Johnson  M, Owers J, Horwood P. Air transport of infants in Newfoundland and Labrador. Canadian Medical Association Journal 1978;119(2):127. 15. Buckland L, et al. Excessive exposure of sick neonates to sound during transport. Archives of Disease in Childhood-Fetal and Neonatal Edition 2003;88(6):513-6. 16. Campbell  AN, et al. Mechanical vibration and sound levels experienced in neonatal transport. American journal of diseases of children 1984;138(10):967-70. 17. Ciesielski S, Kopka J, Kidawa B. Incubator noise and vibration-possible iatrogenic influence on neonate. International journal of pediatric otorhinolaryngology 1980;1(4):309-16.