Procedural Sedation Intubation in a Paramedic-Staffed Helicopter Emergency Medical System in Northern Finland

Show full item record



Permalink

http://hdl.handle.net/10138/340667

Citation

Länkimäki , S , Spalding , M , Saari , A & Alahuhta , S 2021 , ' Procedural Sedation Intubation in a Paramedic-Staffed Helicopter Emergency Medical System in Northern Finland ' , Air Medical Journal , vol. 40 , no. 6 , pp. 385-389 . https://doi.org/10.1016/j.amj.2021.08.012

Title: Procedural Sedation Intubation in a Paramedic-Staffed Helicopter Emergency Medical System in Northern Finland
Author: Länkimäki, Sami; Spalding, Michael; Saari, Antti; Alahuhta, Seppo
Contributor organization: Clinicum
HUS Emergency Medicine and Services
Date: 2021-11-01
Language: eng
Number of pages: 5
Belongs to series: Air Medical Journal
ISSN: 1067-991X
DOI: https://doi.org/10.1016/j.amj.2021.08.012
URI: http://hdl.handle.net/10138/340667
Abstract: Objective: Airway management to ensure sufficient gas exchange is of major importance in emergency care. Prehospital endotracheal intubation (ETI) by paramedics is a widely debated method to ensure a patent airway. ETI is performed with procedural sedation in comatose patients because of the regulation. The use of medications increases the rate of successful airway management compared with nonmedication ETI and may also improve outcomes in patients with traumatic brain injury. In the absence of an operative emergency physician and with long distances, paramedic-induced airway management may increase the survival of patients in selected scenarios. A paramedic-staffed helicopter emergency medical system in Northern Finland operates in a rural area without an emergency physician and paralytic medications and treats critically ill patients using basic or advanced life support ground units. The aim of this study was to evaluate the success rates of ETI performed by a small, appropriately trained, and experienced group of 8 nurse paramedics in an out-of-hospital setting. Methods: The inclusion criterion for the study was an attempted intubation in patients with medical or traumatic indication for airway management by nurse paramedic. Results: Fifty-one patients were treated with ETI. The first-pass success rate was 72.5%, the second-pass success rate was 94.1%, and the overall success rate was 100% within 4 attempts. The median on-scene time was 54 minutes, and there were no signs of aspiration during laryngoscopy or after successful ETI. The primary mortality rate was 11.7%. Conclusion: The use of a rigid standard operating procedure for paramedic rapid sequence induction, paralytics, a video laryngoscope, and a gum elastic bougie might positively affect the ETI first-pass success rate. A follow-up study after these future modifications is needed. This small study suggests that intubation might be 1 option for airway management by an experienced nonanesthesiologist in Lapland.
Description: Publisher Copyright: © 2021 The Authors
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
PIIS1067991X2100170X.pdf 889.2Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record