Airway management by physician-staffed Helicopter Emergency Medical Services - a prospective, multicentre, observational study of 2,327 patients

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dc.contributor.author Sunde, Geir Arne
dc.contributor.author Heltne, Jon-Kenneth
dc.contributor.author Lockey, David
dc.contributor.author Burns, Brian
dc.contributor.author Sandberg, Marten
dc.contributor.author Fredriksen, Knut
dc.contributor.author Hufthammer, Karl Ove
dc.contributor.author Soti, Akos
dc.contributor.author Lyon, Richard
dc.contributor.author Jantti, Helena
dc.contributor.author Kamarainen, Antti
dc.contributor.author Reid, Bjorn Ole
dc.contributor.author Silfvast, Tom
dc.contributor.author Harm, Falko
dc.contributor.author Sollid, Stephen J. M.
dc.contributor.author Airport Study Grp
dc.date.accessioned 2016-05-20T11:46:02Z
dc.date.available 2016-05-20T11:46:02Z
dc.date.issued 2015-08-07
dc.identifier.citation Sunde , G A , Heltne , J-K , Lockey , D , Burns , B , Sandberg , M , Fredriksen , K , Hufthammer , K O , Soti , A , Lyon , R , Jantti , H , Kamarainen , A , Reid , B O , Silfvast , T , Harm , F , Sollid , S J M & Airport Study Grp 2015 , ' Airway management by physician-staffed Helicopter Emergency Medical Services - a prospective, multicentre, observational study of 2,327 patients ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 23 , 57 . https://doi.org/10.1186/s13049-015-0136-9
dc.identifier.other PURE: 53118357
dc.identifier.other PURE UUID: 04be964a-6dd3-4334-8305-bbe89b746c37
dc.identifier.other WOS: 000359043700001
dc.identifier.other Scopus: 84938586781
dc.identifier.uri http://hdl.handle.net/10138/162616
dc.description.abstract Background: Despite numerous studies on prehospital airway management, results are difficult to compare due to inconsistent or heterogeneous data. The objective of this study was to assess advanced airway management from international physician-staffed helicopter emergency medical services. Methods: We collected airway data from 21 helicopter emergency medical services in Australia, England, Finland, Hungary, Norway and Switzerland over a 12-month period. A uniform Utstein-style airway template was used for collecting data. Results: The participating services attended 14,703 patients on primary missions during the study period, and 2,327 (16 %) required advanced prehospital airway interventions. Of these, tracheal intubation was attempted in 92 % of the cases. The rest were managed with supraglottic airway devices (5 %), bag-valve-mask ventilation (2 %) or continuous positive airway pressure (0.2 %). Intubation failure rates were 14.5 % (first-attempt) and 1.2 % (overall). Cardiac arrest patients showed significantly higher first-attempt intubation failure rates (odds ratio: 2.0; 95 % CI: 1.5-2.6; p <0.001) compared to non-cardiac arrest patients. Complications were recorded in 13 %, with recognised oesophageal intubation being the most frequent (25 % of all patients with complications). For non-cardiac arrest patients, important risk predictors for first-attempt failure were patient age (a non-linear association) and administration of sedatives (reduced failure risk). The patient's sex, provider's intubation experience, trauma type (patient category), indication for airway intervention and use of neuromuscular blocking agents were not risk factors for first-attempt intubation failure. Conclusions: Advanced airway management in physician-staffed prehospital services was performed frequently, with high intubation success rates and low complication rates overall. However, cardiac arrest patients showed significantly higher first-attempt failure rates compared to non-cardiac arrest patients. All failed intubations were handled successfully with a rescue device or surgical airway. en
dc.format.extent 10
dc.language.iso eng
dc.relation.ispartof Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Advanced trauma life support
dc.subject Airway management
dc.subject Emergency medical services
dc.subject Intubation
dc.subject Out-of-hospital cardiac arrest
dc.subject TRACHEAL INTUBATION
dc.subject DIFFICULT AIRWAY
dc.subject TRAUMA PATIENTS
dc.subject SUCCESS RATES
dc.subject ANESTHESIOLOGISTS
dc.subject COMPLICATIONS
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Airway management by physician-staffed Helicopter Emergency Medical Services - a prospective, multicentre, observational study of 2,327 patients en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1186/s13049-015-0136-9
dc.relation.issn 1757-7241
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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