The use of an inhalation anesthetic during transportation by a light-class ambulance helicopter of a patient in critical condition

One of the main problems faced by team members performing medical evacuation of patients in serious or critical condition is to provide adequate anesthesia and sedation for neurovegetative protection. Those affected in this condition are in particular need of adequate sedation and analgesia, which prevent agitation and ensure the implementation of intensive care measures, in particular, invasive manipulations. During transportation, including aviation medical, this component becomes more important due to the impact of additional triggers such as vibration, engine noise, acceleration, etc. Recently, there has been an increasing number of studies confirming the benefits of inhaled sedatives as an alternative to intravenous sedatives, especially in patients with invasive respiratory support. Currently, the literature widely presents the results of studies on the use of inhalation sedation in the intensive care unit and intensive care unit, and practically does not cover its use at the pre-hospital stage, especially when performing air medical evacuation, which served as the basis for presenting the following clinical observation to your attention.
The purpose of the study is to demonstrate the possibilities and results of sedation with an inhaled anesthetic to a victim with severe concomitant trauma in critical condition on a ventilator during inter–hospital transportation by a light-class ambulance helicopter.
Materials and methods. The work uses data from the automated information and analytical system «Disaster Medicine of the city of Moscow» of the Moscow State Medical University of a special type «Moscow Territorial Scientific and Practical Center for Disaster Medicine DM», concerning the inter-hospital transportation of patients in critical condition. A call card for ambulance (emergency) medical care teams at the MTNPCMK (CEMP) DZM State Medical Institution.
Methodology. The use of an AnaConDa device for inhalation sedation, which allows for more precise monitoring the dosage and effect of drugs in the cabin of a light-class ambulance helicopter.
The results and their analysis. A clinical case of successful implementation of inhalation sedation and anesthesia on a ventilator during inter-hospital transportation by a light-class helicopter of a victim in critical condition due to a combined injury is presented.
Conclusion. The presented clinical case showed that inhaled sedation and anesthesia with an inhaled anesthetic using an AnaConDa device during hospital-to-hospital transportation of a critically ill patient on a ventilator provides a number of positive effects with a relatively simple and safe technique. In the future, the use of inhaled anesthetics in ambulance practice may help to avoid polypragmasia and, accordingly, reduce the risk of unpredictable side effects and enable sedation and analgesia for severe victims at the scene before immobilization, providing venous access and delivery to the cabin of vehicles or on board an aircraft. It should be noted that performing sedation and anesthesia with inhaled anesthetics at the prehospital stage in critically ill patients requires continued research in this area.

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