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, Mårten | |
dc.contributor.author | Fredriksen, Knut | |
dc.contributor.author | Hufthammer, Karl Ove | |
dc.contributor.author | Soti, Akos | |
dc.contributor.author | Lyon, Richard | |
dc.contributor.author | Jäntti, Helena | |
dc.contributor.author | Kämäräinen, Antti | |
dc.contributor.author | Reid, Bjørn Ole | |
dc.contributor.author | Silfvast, Tom | |
dc.contributor.author | Harm, Falko | |
dc.contributor.author | Sollid, Stephen J. M. | |
dc.date.accessioned | 2016-02-10T12:21:27Z | |
dc.date.available | 2016-02-10T12:21:27Z | |
dc.date.issued | 2015-08-07 | |
dc.description.abstract | <p>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.
<p>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.
<p>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.
<p>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_US |
dc.identifier.citation | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 23(2015) s. - | en_US |
dc.identifier.cristinID | FRIDAID 1265051 | |
dc.identifier.doi | 10.1186/s13049-015-0136-9 | |
dc.identifier.issn | 1757-7241 | |
dc.identifier.uri | https://hdl.handle.net/10037/8458 | |
dc.identifier.urn | URN:NBN:no-uit_munin_8025 | |
dc.language.iso | eng | en_US |
dc.publisher | BioMed Central Ltd. | en_US |
dc.rights.accessRights | openAccess | |
dc.subject | Advanced trauma life support | en_US |
dc.subject | Airway management | en_US |
dc.subject | Emergency medical services | en_US |
dc.subject | Intubation | en_US |
dc.subject | Out-of-hospital cardiac arrest | en_US |
dc.subject | VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Traumatologi: 783 | en_US |
dc.subject | VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Traumatology: 783 | en_US |
dc.title | Airway management by physician-staffed Helicopter Emergency Medical Services – a prospective, multicentre, observational study of 2,327 patients | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |