title: Implementing new advanced airway management standards in the Hungarian physician staffed Helicopter Emergency Medical Service.
abstract: In 2011 the Hungarian Air Ambulance Nonprofit Limited Company introduced a new Rapid Sequence Intubation standard operating procedure using a template from London's Air Ambulance. This replaced a previous ad-hoc and unsafe prehospital advanced airway management practice. It was hoped that this would increase clinical standards including internationally comparable results. All Rapid Sequence Intubations performed by the units of the Hungarian Air Ambulance under the new procedure between June 2011 and November 2013 were reviewed in a retrospective database analysis. During this period the air ambulance units completed 4880 missions with 433 intubations performed according to the new procedure. The rate of intubations that were successful on first attempt was 95.4% (413), while intubation was successful overall in 99.1% (429) of the cases; there was no failed airway. 90 complications were noted with 73 (16.9%) patients. Average on scene time was 49 minutes (ranging between: 15-110 minutes). This data shows that it is possible to effectively change a system that was in place for decades by implementing a new robust system that is based on a good template.
authors.affiliation: Hungarian Air Ambulance Nonprofit Ltd., Legimentok u. 8, Budaors, H-2040, Hungary. akossoti@gmail.com.|National Ambulance Service, Robert K. krt 77, Budapest, H-1134, Hungary. akossoti@gmail.com.
authors.forename: Akos
authors.initials: A
authors.lastname: Soti
authors.affiliation: Hungarian Air Ambulance Nonprofit Ltd., Legimentok u. 8, Budaors, H-2040, Hungary. temesvari.peter@mentok.hu.|National Ambulance Service, Robert K. krt 77, Budapest, H-1134, Hungary. temesvari.peter@mentok.hu.
authors.forename: Peter
authors.initials: P
authors.lastname: Temesvari
authors.affiliation: Hungarian Air Ambulance Nonprofit Ltd., Legimentok u. 8, Budaors, H-2040, Hungary. laszlo.hetzman@airambulance.hu.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hetzman
authors.affiliation: Hungarian Air Ambulance Nonprofit Ltd., Legimentok u. 8, Budaors, H-2040, Hungary. attilaeross@yahoo.co.uk.
authors.forename: Attila
authors.initials: A
authors.lastname: Eross
authors.affiliation: Hungarian Air Ambulance Nonprofit Ltd., Legimentok u. 8, Budaors, H-2040, Hungary. andraspetroczy@gmail.com.|National Ambulance Service, Robert K. krt 77, Budapest, H-1134, Hungary. andraspetroczy@gmail.com.
authors.forename: Andras
authors.initials: A
authors.lastname: Petroczy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D000401:Aircraft; D058109:Airway Management / Q000592:standards*; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006801:Humans; D006814:Hungary; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors