@article{ref1,
title="In-flight pharmacological management of patients with acute mental health disturbance",
journal="Air Medical Journal",
year="2018",
author="Wilkinson, Brian and Garwood, James and Langford, Stephen",
volume="37",
number="2",
pages="115-119",
abstract="OBJECTIVE: Patients can be transferred many hundreds of kilometers with acute mental health disturbance for specialist mental health services in Western Australia. <br><br>METHODS: A retrospective notes review of Royal Flying Doctor Service Western Operations records was undertaken over a 4-month period. Patients were identified from the transfer database by mental health diagnosis. Benzodiazepine and antipsychotic doses were converted into a reference drug per class for comparison. <br><br>RESULTS: One hundred ten patients underwent air transfer in a total of 130 flights. Over 80% of patients were involuntary patients being transferred for specialist psychiatric evaluation and management in an inpatient mental health unit. Over half of the patients required no in-flight sedation, and around 80% of patients were managed with standard doses of first-line agents (haloperidol, midazolam, and diazepam). A small number of patients required alternative agents for refractory sedation, most commonly ketamine and propofol. There were no statistically significant differences for in-flight medication by sex, ethnicity, or substance misuse status. <br><br>CONCLUSIONS: The rate of in-flight incidents including violence remained low. Transfers of patients with acute mental health disturbance are challenging, and quality preflight assessment and in-flight care are required to minimize the associated risks.<br><br>Copyright © 2018 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1067-991X",
doi="10.1016/j.amj.2017.12.002",
url="http://dx.doi.org/10.1016/j.amj.2017.12.002"
}