Display options
Share it on

Scand J Trauma Resusc Emerg Med. 2008 Jul 21;16:2. doi: 10.1186/1757-7241-16-2.

Pre-hospital advanced airway management by anaesthesiologists: is there still room for improvement?.

Scandinavian journal of trauma, resuscitation and emergency medicine

Stephen J M Sollid, Jon Kenneth Heltne, Eldar Søreide, Hans Morten Lossius

Affiliations

  1. Department of Anaesthesia and Intensive care, Division of Acute Care Medicine, Stavanger University Hospital, Stavanger, Norway. [email protected]

PMID: 18957064 PMCID: PMC2556637 DOI: 10.1186/1757-7241-16-2

Abstract

BACKGROUND: Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management.

METHOD: Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians.

RESULTS: Of the 17 available respondents, most (88%) felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment.

CONCLUSION: The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

References

  1. Acta Anaesthesiol Scand. 2008 Aug;52(7):897-907 - PubMed
  2. Anesth Analg. 2007 Mar;104(3):619-23 - PubMed
  3. Prehosp Emerg Care. 2007 Jan-Mar;11(1):72-9 - PubMed
  4. Prehosp Emerg Care. 2007 Jan-Mar;11(1):1-8 - PubMed
  5. Acta Anaesthesiol Scand. 2006 Nov;50(10):1250-4 - PubMed
  6. Curr Opin Anaesthesiol. 2004 Dec;17(6):511-2 - PubMed
  7. Resuscitation. 2006 Aug;70(2):179-85 - PubMed
  8. Chest. 2006 Jun;129(6):1453-8 - PubMed
  9. Acta Anaesthesiol Scand. 2006 Mar;50(3):290-7 - PubMed
  10. Best Pract Res Clin Anaesthesiol. 2005 Dec;19(4):539-57 - PubMed
  11. Resuscitation. 2005 Dec;67 Suppl 1:S39-86 - PubMed
  12. Med Teach. 2005 Jan;27(1):10-28 - PubMed
  13. Acta Anaesthesiol Scand. 2005 Oct;49(9):1339-45 - PubMed
  14. Ann Emerg Med. 1998 Oct;32(4):454-60 - PubMed
  15. Anesth Analg. 1998 Mar;86(3):635-9 - PubMed
  16. Respir Care. 2004 Oct;49(10):1181-5 - PubMed
  17. Acta Anaesthesiol Scand. 2004 Sep;48(8):1014-8 - PubMed
  18. Anesth Analg. 2004 Aug;99(2):607-13, table of contents - PubMed
  19. Anaesthesist. 2004 Jun;53(6):543-50 - PubMed
  20. Resuscitation. 2004 Apr;61(1):9-21 - PubMed
  21. Anesth Analg. 2002 Aug;95(2):411-6, table of contents - PubMed
  22. Acta Anaesthesiol Scand. 2001 Oct;45(9):1181-5 - PubMed

Publication Types