R. Weston1, D. Chesire1, D. Meysenburg1, J. Fortner1, R. Houghton1, K. Solomon1, B. Burns1 1University Of Florida,College Of Medicine,Jacksonville, FL, USA
Introduction: Airway compromise has been identified as a preventable cause of poor outcomes and death in trauma patients. Given its importance, pre-hospital airway management is vital and can be used as a valuable indicator of critical care quality. The purpose of this study was to analyze successful pre-hospital airway management performed by helicopter flight staff.
Methods: This retrospective chart review evaluated all flight crew airway interventions involving trauma patients between January 1, 2008 through December 31, 2013. Descriptive statistics were used on the number of successful intubations as well as alternative airways.
Results: Of a total of 191 trauma patients requiring airway intervention, 167 were endotracheal intubations (87.4%), 24 were alternative airway intervention such as laryngeal mask airway, combitube or bag valve mask (12.5%). Of the endotracheal intubations, 80.1% were successfully placed by flight crew on their first attempt and the overall success rate was 94.2%. Of the intubations attempted by the flight crew, 43 patients had unsuccessful attempted endotracheal intubation by ground crew. Of these, the flight crew was ultimately successful at placing an endotracheal tube in 41/43 (95.3%) trauma patients.
Conclusion: High endotracheal success rate by flight personnel suggests that medical air transport is more than just an expedited transport mode to the hospital; it can be considered a mobile critical care unit. The fact that 95.3% of previously attempted airways were “rescued” by the flight crew further demonstrates a higher level of care administered in the field