[Long distance air transport by helicopter of a patient with severe head damage]

A report of a case of a patient with severe head trauma with pneumonia and cerebral infarction transported by helicopter. An eighty-year-old male was referred to our hospital because of dyspnea after a fall during sightseeing at Hiroshima. He was lucid at first, but, after two days presented restlessness due to brain contusional hemorrhage and edema. Moreover, he developed pneumonia and cerebral infarction during the period of his hospitalization. He was intubated and received central venous routing. While being transported, his consciousness showed moderate disturbance, aphasia and right hemiplegia. His family asked that therapy be continued near his house in Osaka. We selected transport by helicopter because of his bad general condition and because transport time would be much shorter. He was transported by helicopter to Osaka one month after admission. First, he was transported by ambulance to the airport of Hiroshima. He was carried to the helicopter at the airport. An oxygen cylinder was connected to the incubation tube via an ambu bag because direct connection between the oxygen cylinder and the intubation tube was impossible. Just before the take off, O2 saturation was checked by the pulse oximeter of the ambulance. In the helicopter, there were six men; two pilots, two rescue men, one doctor and the patient. Suction was applied only once and there was no trouble during the flight. The weather was fine and the helicopter experienced almost no rolling during the flight. The flight time was only one hour and twenty minutes. The helicopter safely landed at an emergency heliport in Osaka. The patient was carried to a waiting ambulance and transported to the hospital. Total transport time was only two hours and thirty minutes. This is a case showing a helicopter could safely transport a patient with severe brain damage over a long distance in a short time.