Up, Up, and Away: Aeromedical Transport Physiology

Initially developed by the military through wartime experiences, aeromedical transport has become the cornerstone of many pediatric and neonatal transport programs. Expedited transport of critically ill pediatric patients via rotor- or fixed-wing aircraft may improve outcomes when clinical conditions warrant the rapid delivery of patients to qualified medical centers. However, air transport provides many unique problems for practitioners. Confined space, vibration, noise, and physiologic derangements from high altitude and low cabin pressure are all unique variables encountered during air transport. A sound understanding of these effects with their potential consequences is of paramount importance. Anticipating complications from these physiologic changes is necessary for management and appropriate equipment utilization during transfer. This review explores the history of air transport, associated physiologic changes, and specific equipment needs for transporting this unique patient population.