Airway management in the air medical setting

Brown, Lawrence H., Hubble, Michael W., Wilfong, Denise A., Hertelendy, Attila, and Benner, Randall W. (2011) Airway management in the air medical setting. Air Medical Journal, 30 (3). pp. 140-148.

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Abstract

Background Airway management is a key component of air medical care for seriously ill and injured patients. This meta-analysis of the prehospital airway management literature explored the pooled air-medical placement success rates for oral endotracheal intubation (OETI), including rapid sequence intubation (RSI) and drug-facilitated intubation (DFI), nasotracheal intubation (NTI), blind insertion airway devices (BIAD), and surgical cricothyrotomy (SCRIC).

Methods We performed a systematic literature search for all English language articles reporting success rates for airway procedures performed in the prehospital setting. After identifying articles specific to the air-medical environment, pooled estimates of success rates for each airway technique were calculated using a random effects meta-analysis model.

Results Thirty-six unique studies, encompassing 4,574 procedures, reported airway management success rates in the air medical environment. The pooled estimates (95% CI) for intervention success across all clinicians and patients were: OETI (without RSI/DFI): 86.4% (81.2%–90.3%); DFI: 95.1% (84.1%–98.6%); RSI: 96.7% (94.8%–97.9%); NTI: 76.1% (71.9%–79.9%); BIAD: 94.0% (85.8%–97.6%); and SCRIC: 90.8% (80.6%–95.9%).

Conclusion We provide pooled estimates for airway management procedural success rates in the air medical setting. These data can be used by program managers and medical directors in determining the most appropriate airway management procedures to incorporate into their services and for benchmarking in quality improvement activities.

Item ID: 17262
Item Type: Article (Research - C1)
ISSN: 1532-6497
Keywords: emergency medical services, paramedic, intubation, airway management, RSI, orotracheal intubation
Date Deposited: 15 Jun 2011 00:18
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110999 Neurosciences not elsewhere classified @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920115 Respiratory System and Diseases (incl. Asthma) @ 50%
92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 50%
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