Abstract
BackgroundPre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset.MethodsWe recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe. We used a five-step modified nominal group technique to revise the dataset, and clinical study results from the original template were used to guide the process.ResultsThe experts agreed on a key dataset of thirty-two operational variables with six additional system variables, organised in time, patient, airway management and system sections. Of the original variables, one remained unchanged, while nineteen were modified in name, category, definition or value. Sixteen new variables were added. The updated dataset covers risk factors for difficult intubation, checklist and standard operating procedure use, pre-oxygenation strategies, the use of drugs in airway management, airway currency training, developments in airway devices, airway management strategies, and patient safety issues not previously described.ConclusionsUsing a modified nominal group technique with international airway management experts, we have updated the Utstein-style dataset to report standardised data from pre-hospital advanced airway management. The dataset enables future airway management research to produce comparable high-quality data across emergency medical systems. We believe this approach will promote research and improve treatment strategies and outcomes for patients receiving pre-hospital advanced airway management.Trial registrationThe Regional Committee for Medical and Health Research Ethics in Western Norway exempted this study from ethical review (Reference: REK-Vest/2017/260).
Highlights
Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients
Templates for documenting and reporting of standardised data have been developed by similar methodology for out-of-hospital cardiac arrest, paediatric advanced life support, in-hospital cardiac arrest resuscitation, major incidents and disaster management, laboratory cardiopulmonary research, major trauma, emergency medical dispatch, physician staffed emergency medical services and drownings [10,11,12,13,14,15,16,17,18,19]
Definition of Pre-hospital advanced airway management (PHAAM) The expert group decided to keep the definition of advanced airway management unchanged from the original template, as “the attempted insertion of an advanced airway adjunct or administration of ventilatory assistance”
Summary
Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. Pre-hospital advanced airway management (PHAAM) with the control of oxygenation and ventilation is vital in the management of critically ill or injured patients in the field and may contribute to better outcomes [1,2,3]. To improve pre-hospital critical care and to develop evidence-based guidelines, research based on standardised high-quality data is important [5, 6]. Developments in airway management devices, airway management strategies and training, along with patient safety issues; require that such templates are updated on a regular basis like clinical guidelines and recommendations [20]
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