Airway Management Success and Hypoxemia Rates in Air and Ground Critical Care Transport: a Prospective Multicenter Study

Abstract

CCT crews' ETI success rates were very high, and even when ETI required multiple attempts, airway management was rarely associated with SpO(2) derangement. CCT crews' ETI success rates were equally high in the subset of patients in whom ground emergency medical services (EMS) ETI failed prior to arrival of transport crews.

Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting

“…Available evidence suggests that HEMS-performed ETI is highly successful and improves outcomes in some types of patients [1][2][3][4]. Helicopter emergency Drug administration and 1st set of postdrug VS 3.5 (2-6) 5 (3)(4)(5)(6)(7)(8)(9) .07…”

“…Although outcome data and opinion are mixed with regard to prehospital ground EMS ETI, existing evidence suggests that HEMS-performed ETI is highly successful and improves outcomes in selected patients [1][2][3][4].…”

“…The commendable ETI performance of HEMS crews is related, in part, to training and skills maintenance, but there is an additional contributor: access to an airway pharmacopoeia that is more extensive than that which is often available to ground EMS [1,2].…”

“…Concern over hypotension has been a predominant force driving the adoption of the blood pressure (BP)-sparing agent etomidate as a preferred agent for HEMS crew airway management [7]. Despite some lingering debate over etomidate's safety in some patient subsets, the imidazole hypnotic has been a top choice for air medical providers [1,8,9]. Although its potential use in situations in which NMB is contraindicated contributes to etomidate's widespread use, the main advantage of the drug is its maintenance of peri-ETI BP in critically ill and injured patients [7,[10][11][12][13][14].…”

Prehospital Airway Management

“…Generally speaking, all operators think that their personal experience is the main reason for an optimal airway management (Wang et al 2005. However, in many cases, if the operator has low levels of experience and carries out a small number of intubations per year, an endotracheal intubation might be unfeasible (Thomas et al, 2010). Airway skill maintenance is a real problem because many paramedics or physicians do not manage a sufficient number of cases to be able to manage complex situations.…”