Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations

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Gellerfors , M , Fevang , E , Bäckman , A , Krüger , A , Mikkelsen , S , Nurmi , J , Rognås , L , Sandström , E , Skallsjö , G , Svensén , C , Gryth , D & Lossius , H M 2018 , ' Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations ' , British Journal of Anaesthesia , vol. 120 , no. 5 , pp. 1103-1109 . https://doi.org/10.1016/j.bja.2017.12.036

Title: Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations
Author: Gellerfors, M.; Fevang, E.; Bäckman, A.; Krüger, A.; Mikkelsen, S.; Nurmi, J.; Rognås, L.; Sandström, E.; Skallsjö, G.; Svensén, C.; Gryth, D.; Lossius, H.M.
Contributor: University of Helsinki, Clinicum
Date: 2018-05
Language: eng
Number of pages: 7
Belongs to series: British Journal of Anaesthesia
ISSN: 0007-0912
URI: http://hdl.handle.net/10138/236567
Abstract: Background: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams. Methods: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management. The patients served by six ambulance helicopters and six rapid response vehicles in Denmark, Finland, Norway, and Sweden from May 2015 to November 2016 were included. Results: The critical care teams attended to 32 007 patients; 2028 (6.3%) required pre-hospital tracheal intubation. The overall success rate of pre-hospital tracheal intubation was 98.7% with a median intubation time of 25 s and an on-scene time of 25 min. The majority (67.0%) of the patients' tracheas were intubated by providers who had performed >2500 tracheal intubations. The success rate of tracheal intubation on the first attempt was 84.5%, and 95.9% of intubations were completed after two attempts. Complications related to pre-hospital tracheal intubation were recorded in 10.9% of the patients. Intubations after rapid sequence induction had a higher success rate compared with intubations without rapid sequence induction (99.4% vs 98.1%; P=0.02). Physicians had a higher tracheal intubation success rate than nurses (99.0% vs 97.6%; P=0.03). Conclusions: When performed by experienced physician anaesthetists and nurse anaesthetists, pre-hospital tracheal intubation was completed rapidly with high success rates and a low incidence of complications.
Subject: ADVERSE EVENTS
CLINICAL-PRACTICE
EMERGENCY MEDICAL-SERVICES
GUIDELINES
HYPOTENSION
MULTICENTER
PHYSICIAN
RAPID-SEQUENCE INTUBATION
STATEMENT
TRAUMATIC BRAIN-INJURY
airway management
emergency medical services
intratracheal
intubation
316 Nursing
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