Performance of endotracheal intubation and rescue techniques by emergency services personnel in an air medical service.
BACKGROUND
Literature spanning the last two decades has identified potential harm associated with out-of-hospital endotracheal intubation performed by ground paramedics. Previous researchers have reported intubation success rates of 66% to 97% in the air medical setting.


OBJECTIVE
To examine the success of endotracheal intubation and rescue techniques performed by air medical personnel during the first eight years of operation of the air ambulance service.


METHODS
This study was a retrospective survey of health records utilizing data from LifeFlight of Maine's airway procedure quality review database, covering the first eight years of system encounters.


RESULTS
During the study period, 369 intubation encounters occurred. Rapid-sequence intubation medications were administered in 345 (93.5%) cases. Flight personnel successfully performed endotracheal intubation in 340 (92.1%) encounters. Unsuccessful intubations were managed with an alternative definitive airway, rescue airway, or bag-valve-mask. Laryngeal mask airway (n = 11) was the most commonly used rescue airway device.


CONCLUSIONS
During the first eight years of operation of this air medical transport system, flight personnel were able to successfully perform endotracheal intubation in 92.1% of cases.
Germann
Carl A
CA
Department of Emergency Medicine, Maine Medical Center, Portland, Maine 04102, USA. germac@mmc.org
Baumann
Michael R
MR
Kendall
Kevin M
KM
Strout
Tania D
TD
McGraw
Kim
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D002983:Clinical Competence; D004634:Emergency Medical Technicians / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008281:Maine; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D055815:Young Adult