Advanced airway management is necessary in prehospital trauma patients

Abstract

A significant proportion of severely injured trauma patients required advanced airway interventions to effectively treat airway compromise. Standard ambulance service interventions were only effective for a proportion of patients, but might not have always been applied appropriately. Complications of advanced airway management occurred in both provider groups, but failed intubation and unrecognized oesophageal intubation were a particular problem in the paramedic intubation group.

Use of the GlideScope Ranger Video Laryngoscope for Emergency Intubation in the Prehospital Setting: A Randomized Control Trial*

“…Finally, because the primary target was to evaluate intubation success rates, outcome data of the patients requiring advanced airway management in the field were not assessed. Thus, we are not able to contribute to the discussion about the potential impact of advanced airway management on outcome, which is ongoing and controversial (37)(38)(39). In conclusion, video laryngoscopy is a state of the art tool in difficult airway management, but our results shed light on the specific problems in the EMS setting.…”

Prehospital emergency anaesthesia: an updated survey of UK practice with emphasis on the role of standardisation and checklists

“…A subset of patients may require tracheal intubation prior to hospital arrival to ensure a patent airway, adequate oxygenation and optimal ventilation 1. The recommended method for prehospital emergency anaesthesia (PHEA or ‘prehospital rapid sequence intubation’) is one using hypnotic drugs and muscle relaxation, followed by oral tracheal intubation 2 3.…”

Progress in difficult airway management

“…In addition to the development of new reliable airway devices and routine use of oximetry and capnography, guidelines regarding difficult airway management have been formulated by several different societies [4][5][6]. Nevertheless, the current strategies for airway management are still not ideal [7][8][9][10][11] and, therefore, we need to update our knowledge to improve airway management further. This editorial describes some new findings which would reduce serious complications associated with airway management.…”