Life Link III, Bloomington, MN.
Air Med J. 2021 Jan-Feb;40(1):16-19. doi: 10.1016/j.amj.2020.11.009. Epub 2020 Nov 23.
Helmet-based noninvasive ventilation (NIV) is a viable option for the safe transport of potential or known coronavirus disease 2019 patients. Given the most likely modes of transmission through droplets, aerosols, and fomite contact, airway procedures such as endotracheal intubation place air medical crews and other health care providers at high risk for exposure. This, together with data that suggest that a large cohort of coronavirus disease 2019 patients have better outcomes if we can avoid intubating them, creates a need for a safe method of NIV or high-flow oxygen delivery during transport. Commonly used and successful in-hospital regimens for these patients are high-flow nasal cannula and continuous positive airway pressure or bilevel positive airway pressure. In some studies, helmet NIV has been shown to be a viable, if not superior, alternative to these therapies for patients with acute hypoxemic respiratory failure. Furthermore, because it is a sealed and closed space that completely isolates the patient's airway and breathing, it provides a very high degree of protection from exposure to pathogens transmitted through droplets or aerosols. This article discusses practical implementation of helmet NIV in air medical transport.
头盔式无创通气（NIV）是安全转运疑似或已知 2019 年冠状病毒病患者的可行选择。鉴于最可能的传播途径是飞沫、气溶胶和接触传播，气道操作，如气管插管，使航空医疗人员和其他医护人员面临极高的暴露风险。此外，如果我们能够避免对这些患者进行插管，那么很大一部分 2019 年冠状病毒病患者会有更好的预后，这两者结合在一起，使得在转运过程中需要一种安全的 NIV 或高流量氧气输送方法。这些患者常用且有效的院内治疗方案是高流量鼻导管和持续气道正压通气或双水平气道正压通气。在一些研究中，头盔式 NIV 已被证明是急性低氧性呼吸衰竭患者替代这些治疗方法的可行选择，甚至可能更优。此外，由于它是一个封闭的空间，完全隔离了患者的气道和呼吸，因此它能提供极高程度的保护，防止通过飞沫或气溶胶传播的病原体的暴露。本文讨论了在航空医疗转运中实际实施头盔式 NIV 的问题。
