AIR EVACUATION OF CRITICALLY BURNED PATIENTS

We analyze the repercussions of air evacuation on the physiopathology of the critically burned patient based on the experience of 63 patient s evacuated by air, Clinical repercussions are due to accelerations, v ibrations, noise, and, primarily, to altitude, Accelerations are impor tant during take-off and landing, and vibrations may be important in h elicopter evacuations in the presence of craniofacial trauma, The nois e, especially in helicopters, can interfere with diagnostic and therap eutic maneuvers in-flight, The altitude modifies atmospheric pressure, partial pressure of oxygen, and water concentration in inhaled air, I n the aircraft we use, atmospheric pressure is between 550 and 532 mm Hg at the normal flight altitudes. This situation determines the expan sion of body gases. Hypoxia seriously worsens any respiratory insuffic iency, primarily in the presence of smoke inhalation, The decrease of water concentration in the inhaled air compels the increase of fluid p erfusion. Pre-flight and in-flight measures are analyzed, especially w ith regard to smoke inhalation, pneumothorax, and parenteral perfusion .