Performance of Endotracheal Intubation and Rescue Techniques by Emergency Services Personnel in an Air Medical Service

Abstract

BACKGROUND: Literature spanning the last two decades has identified potential harm associated with out-of-hospital endotracheal intubation performed by ground paramedics. Previous researchers have reported intubation success rates of 66% to 97% in the air medical setting. OBJECTIVE: To examine the success of endotracheal intubation and rescue techniques performed by air medical personnel during the first eight years of operation of the air ambulance service. METHODS: This study was a retrospective survey of health records utilizing data from LifeFlight of Maine's airway procedure quality review database, covering the first eight years of system encounters. RESULTS: During the study period, 369 intubation encounters occurred. Rapid-sequence intubation medications were administered in 345 (93.5%) cases. Flight personnel successfully performed endotracheal intubation in 340 (92.1%) encounters. Unsuccessful intubations were managed with an alternative definitive airway, rescue airway, or bag-valve-mask. Laryngeal mask airway (n = 11) was the most commonly used rescue airway device. CONCLUSIONS: During the first eight years of operation of this air medical transport system, flight personnel were able to successfully perform endotracheal intubation in 92.1% of cases.