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High-frequency percussive ventilation for intercontinental aeromedical evacuation

COL David J. Barillo, MD, FACS, FCCM, COL Evan M. Renz, MD, SFC Gabriel R. Wright, CRT, MAJ Kristine P. Broger, CCRN, LTC Kevin K. Chung, MD, Charles K. Thompson, PA-C, COL Leopoldo C. Cancio, MD, FACS


High-frequency percussive ventilation (HFPV) has been used for the management of patients with smoke inhalation injury for more than 20 years and is considered a standard of care at many burn centers. Because the ventilator is powered by air and oxygen rather than electricity, prehospital use has been limited by largevolume medical gas requirements.
Since 2003, Operations Iraqi Freedom and Enduring Freedom have created a need for long-range aeromedical transfer of service members with severe burn and inhalation injuries. Unique to these conflicts is the availability of US Air Force C-17 cargo aircraft as the primary longdistance airframe. Because C-17 aircraft have a built-in medical oxygen supply, transcontinental patient transport using HFPV has become feasible.
In this study, the authors report their initial experiences with the aeromedical transportation of 33 burn patients over a combined distance of 174,145 air miles using HFPV. HFPV is safe and efficacious for transcontinental flight when used by an experienced medical transport team.


burn, trauma, aeromedical transport, high-frequency percussive ventilation, critical care air transport

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