title: AAGBI: Safer pre-hospital anaesthesia 2017: Association of Anaesthetists of Great Britain and Ireland.
abstract: Pre-hospital emergency anaesthesia with oral tracheal intubation is the technique of choice for trauma patients who cannot maintain their airway or achieve adequate ventilation. It should be carried out as soon as safely possible, and performed to the same standards as in-hospital emergency anaesthesia. It should only be conducted within organisations with comprehensive clinical governance arrangements. Techniques should be straightforward, reproducible, as simple as possible and supported by the use of checklists. Monitoring and equipment should meet in-hospital anaesthesia standards. Practitioners need to be competent in the provision of in-hospital emergency anaesthesia and have supervised pre-hospital experience before carrying out pre-hospital emergency anaesthesia. Training programmes allowing the safe delivery of pre-hospital emergency anaesthesia by non-physicians do not currently exist in the UK. Where pre-hospital emergency anaesthesia skills are not available, oxygenation and ventilation should be maintained with the use of second-generation supraglottic airways in patients without airway reflexes, or basic airway manoeuvres and basic airway adjuncts in patients with intact airway reflexes.
authors.affiliation: North Bristol NHS Trust, AAGBI Working Party, Bristol University, Bristol, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Lockey
authors.affiliation: Anaesthetics and Intensive Care Medicine, Severn Deanery, UK.
authors.forename: K
authors.initials: K
authors.lastname: Crewdson
authors.affiliation: Royal London Hospital/Royal College of Emergency Medicine, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Davies
authors.affiliation: Cardiff University, Cardiff, UK.
authors.forename: B
authors.initials: B
authors.lastname: Jenkins
authors.affiliation: Derby Hospitals NHS Foundation Trust, Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Klein
authors.affiliation: British Association for Immediate Care, Auchterarder, Perthshire, UK.
authors.forename: C
authors.initials: C
authors.lastname: Laird
authors.affiliation: Royal Centre for Defence Medicine, Imperial College, London, UK.
authors.forename: P F
authors.initials: PF
authors.lastname: Mahoney
authors.affiliation: Royal United Hospital, Bath, Anaesthesia and Intensive Care Medicine/Resuscitation Medicine at Bristol University, Royal College of Anaesthetists, Bristol, UK.
authors.forename: J
authors.initials: J
authors.lastname: Nolan
authors.affiliation: Mid-Yorkshire NHS Trust, British Association for Immediate Care, Ipswich, Suffolk, UK.
authors.forename: A
authors.initials: A
authors.lastname: Pountney
authors.affiliation: North Bristol NHS Trust, AAGBI Board, Bristol, UK.
authors.forename: S
authors.initials: S
authors.lastname: Shinde
authors.affiliation: Countess of Chester Hospital, AAGBI Board, Chester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tighe
authors.affiliation: Kent, Surrey, Sussex Air Ambulance Trust, Royal College of General Practitioners, Tonbridge, UK.
authors.forename: M Q
authors.initials: MQ
authors.lastname: Russell
authors.affiliation: Royal United Hospital Bath, Group of Anaesthetists in Training, AAGBI, Avon, UK.
authors.forename: J
authors.initials: J
authors.lastname: Price
authors.affiliation: St Mary's Major Trauma Centre, Imperial College, Military Pre-hospital Emergency Medicine, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Wright
mesh_terms: D006801:Humans; D058109:Airway Management / Q000592:standards; D000758:Anesthesia / Q000379:methods / Q000592:standards; D000776:Anesthesiology / Q000193:education / Q000295:instrumentation; D002983:Clinical Competence; D016292:Procedural Sedation / Q000379:methods / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards; D004632:Emergency Medical Services / Q000458:organization & administration / Q000592:standards; D007442:Intubation, Intratracheal / Q000379:methods / Q000592:standards; D007494:Ireland; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D014187:Transportation of Patients / Q000592:standards; D006113:United Kingdom; D014947:Wounds and Injuries / Q000628:therapy
keywords: ambulance; anaesthesia; emergency; pre-hospital; trauma