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Maeyama, Hiroki Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Naitou, Hiromichi Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Guyette, Francis X. Department of Emergency Medicine, University of Pittsburgh School of Medicine
Yorifuji, Takashi Department of Epidemiology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Banshotani, Yuki Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital
Matsui, Daisaku Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital
Yumoto, Tetsuya Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Nakao, Atsunori Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
Kobayashi, Makoto Tajima Emergency and Critical Care Medical Center, Toyooka Public Hospital
Abstract
Introduction The Helicopter Emergency Medical Service (HEMS) commonly intubates patients who require advanced airway support prior to takeoff. In-flight intubation (IFI) is avoided because it is considered difficult due to limited space, difficulty communicating, and vibration in flight. However, IFI may shorten the total prehospital time. We tested whether IFI can be performed safely by the HEMS. Methods We conducted a retrospective cohort study in adult patients transported from 2010 to 2017 who received prehospital, non-emergent intubation from a single HEMS. We divided the cohort in two groups, patients intubated during flight (flight group, FG) and patients intubated before takeoff (ground group, GG). The primary outcome was the proportion of successful intubations. Secondary outcomes included total prehospital time and the incidence of complications. Results We analyzed 376 patients transported during the study period, 192 patients in the FG and 184 patients in the GG. The intubation success rate did not differ between the two groups (FG 189/192 [98.4%] vs. GG 179/184 [97.3%],p = 0.50). There were also no differences in hypoxia (FG 4/117 [3.4%] vs. GG 4/95 [4.2%],p = 1.00) or hypotension (FG 6/117 [5.1%] vs. GG 5/95 [5.3%],p = 1.00) between the two groups. Scene time and total prehospital time were shorter in the FG (scene time 7 min vs. 14 min,p < 0.001; total prehospital time 33.5 min vs. 40.0 min,p < 0.001). Conclusions IFI was safely performed with high success rates, similar to intubation on the ground, without increasing the risk of hypoxia or hypotension. IFI by experienced providers shortened transportation time, which may improve patient outcomes.
Keywords
Transportation
Airway management
Air ambulance
Time-to-treatment
Published Date
2020-09-07
Publication Title
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume
volume28
Issue
issue1
Publisher
BMC
Start Page
89
ISSN
1757-7241
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© The Author(s). 2020
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isVersionOf https://doi.org/10.1186/s13049-020-00784-z
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http://creativecommons.org/licenses/by/4.0/.