Refraining from pre-hospital advanced airway management: A prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service

6Citations
Citations of this article
32Readers
Mendeley users who have this article in their library.

Abstract

Introduction: We report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions.Materials and methods: Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) registered data from February 1st 2011 to October 31st 2012. Included were patients of all ages for whom pre-hospital advanced airway management were considered but not performed. The main objectives were to investigate (1) the pre-hospital critical care anaesthesiologists' reasons for considering performing pre-hospital advanced airway management in this group of patients (2) the pre-hospital critical care anaesthesiologists' reasons for not performing pre-hospital advanced airway management (3) the methods used to treat these patients (4) the incidence of complications related to pre-hospital advanced airway management not being performed.Results: We registered data from 1081 cases in which the pre-hospital critical care anaesthesiologists' considered performing pre-hospital advanced airway management. The anaesthesiologists decided to withhold pre-hospital advanced airway management in 32.1% of these cases (n = 347). In 75.1% of these cases (n = 257) pre-hospital advanced airway management were withheld because of the patient's condition and in 30.8% (n = 107) because of patient co-morbidity. The most frequently used alternative treatment was bag-mask ventilation, used in 82.7% of the cases (n = 287). Immediate complications related to the decision of not performing pre-hospital advanced airway management occurred in 0.6% of the cases (n = 2).Conclusion: We have illustrated the complexity of the critical decision-making associated with pre-hospital advanced airway management. This study is the first to identify the most common reasons why pre-hospital critical care anaesthesiologists sometimes choose to abstain from pre-hospital advanced airway management as well as the alternative treatment methods used. © 2013 Rognås et al.; licensee BioMed Central Ltd.

Cite

CITATION STYLE

APA

Rognås, L., Hansen, T. M., Kirkegaard, H., & Tønnesen, E. (2013). Refraining from pre-hospital advanced airway management: A prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 21(1). https://doi.org/10.1186/1757-7241-21-75

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free