Aeromedical evacuation of a COVID-19 patient from a zonal hospital: A case report

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected the whole world including many healthcare workers. In this era of ongoing global pandemic, the patient surge for aeromedical evacuation is going to increase. Case Details: A 54-year, male healthcare worker with no known co-morbidities, presented with complains of fever, myalgia, and sore throat at a zonal hospital of Indian Air Force in the northeast part of India. He was diagnosed with COVID-19 related bilateral extensive pneumonia. Despite of standard treatment, his condition deteriorated. An aeromedical evacuation of the patient was carried out to a tertiary healthcare centre at Delhi which involved 4-h of flying time. The Airborne Rescue Pod for Isolated Transportation (ARPIT) isolation pod was used to minimize the risk of contamination. Discussion: This was the first time that a COVID-19 patient was air evacuated in an isolation pod in Indian Armed Forces to the best of our knowledge. Based on our experience, we recommend that air evacuation of such a patient may be resorted to only as a life saving measure. The use of an isolation pod remains an unsettled issue; whereas, it gives absolute containment to spread of infection, it poses unique challenges in terms of handling the patient in case of an in-flight emergency. Certain modifications in the isolation pod have been recommended.

Hormonal and Subjectively Perceived Stress of the Emergency Physicians of the Airborne Rescue Service

Due to their work activities, emergency physicians are regularly exposed to exceptional mental and physical situations. In order to prevent stress-related illnesses, the triggers of hormonal and subjectively perceived stress must be understood better. On a sample of emergency physicians from two air rescue services (N = 80), the cortisol awakening response (CAR) was determined on flight rescue days, clinic days, and days off. Pearson correlations showed significant connections between the CAR on flight rescue days and individual scales of the Trier Inventory for Chronic Stress (TICS) and the Perceived Stress Scale (PSS). The results indicate that a lower subjective stress level is associated with higher levels of hormonal stress. Stepwise regression analyses showed a significant influence of the number of professional years, subjectively perceived stress, pressure to succeed, and social isolation. The results suggest that the hormonal stress burden of emergency physicians is in a complex relationship with perceived strain.