Abstract
BackgroundAdvanced airway management is a critical intervention that can harm the patient if performed poorly. The available literature on this subject is rich, but it is difficult to interpret due to a huge variability and poor definitions. Several initiatives from large organisations concerned with airway management have recently propagated the need for guidelines and standards in pre-hospital airway management. Following the path of other initiatives to establish templates for uniform data reporting, like the many Utstein-style templates, we initiated and carried out a structured consensus process with international experts to establish a set of core data points to be documented and reported in cases of advanced pre-hospital airway management.MethodsA four-step modified nominal group technique process was employed.ResultsThe inclusion criterion for the template was defined as any patient for whom the insertion of an advanced airway device or ventilation was attempted. The data points were divided into three groups based on their relationship to the intervention, including system-, patient-, and post-intervention variables, and the expert group agreed on a total of 23 core data points. Additionally, the group defined 19 optional variables for which a consensus could not be achieved or the data were considered as valuable but not essential.ConclusionWe successfully developed an Utstein-style template for documenting and reporting pre-hospital airway management. The core dataset for this template should be included in future studies on pre-hospital airway management to produce comparable data across systems and patient populations and will be implemented in systems that are influenced by the expert panel.
Highlights
Advanced airway management is a critical intervention that can harm the patient if performed poorly
Most published studies that have influenced practice are from pre-hospital systems in North America, where paramedics and nurses usually manage the airway of patients
The expert panel agreed that any patient receiving advanced airway management, defined as the attempted insertion of an advanced airway adjunct or administration of ventilatory assistance, should meet inclusion criteria
Summary
Advanced airway management is a critical intervention that can harm the patient if performed poorly. Advanced airway management is a critical intervention that is carried out regularly on the most severely ill or injured patients in the pre-hospital setting. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17:58 http://www.sjtrem.com/content/17/1/58 formed poorly, pre-hospital airway management is hazardous and can worsen the outcome [4,5,6,7]. Studies on this subject are difficult to interpret because of the huge variability and poor definition of operator experience, technique, and patient case mix [1]. There are certainly several key studies that seriously question the safety of paramedic advanced airway management in US systems [4,5,10,11]
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