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Pediatric Prehospital Advanced Airway Management by Anesthesiologist and Nurse Anesthetist Staffed Critical Care Teams

Published online by Cambridge University Press:  13 July 2021

Mattias Renberg Open the ORCID record for Mattias Renberg [Opens in a new window] ,
Daniel Hertzberg ,
Daniel Kornhall ,
Mattias Günther  and
Mikael Gellerfors
Mattias Renberg*
Affiliation:
Department of Anesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden
Daniel Hertzberg
Affiliation:
Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Daniel Kornhall
Affiliation:
Swedish Air Ambulance (SLA), Mora, Sweden East Anglian Air Ambulance, Cambridge, UK
Mattias Günther
Affiliation:
Department of Clinical Research and Education, Karolinska Institutet, Stockholm, Sweden
Mikael Gellerfors
Affiliation:
Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden Swedish Air Ambulance (SLA), Mora, Sweden Rapid Response Car, Capio, Stockholm, Sweden
*
Correspondence: Mattias Renberg, MD Sjukhusbacken 10, 118 83 Stockholm, Sweden E-mail: renberg.mattias@gmail.com
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Abstract

Introduction:

Prehospital pediatric tracheal intubation (TI) is a possible life-saving intervention that requires adequate experience to mitigate associated complications. The pediatric airway and respiratory physiology present challenges in addition to a relatively rare incidence of prehospital pediatric TI.

Study Objective:

The aim of this study was to describe characteristics and outcomes of prehospital TI in pediatric patients treated by critical care teams.

Methods:

This is a sub-group analysis of all pediatric (<16 years old) patients from a prospective, observational, multi-center study on prehospital advanced airway management in the Nordic countries from May 2015 through November 2016. The TIs were performed by anesthesiologists and nurse anesthetists staffing six helicopter and six Rapid Response Car (RRC) prehospital critical care teams.

Results:

In the study, 74 children were tracheal intubated, which corresponds to 3.7% (74/2,027) of the total number of patients. The pediatric patients were intubated by very experienced providers, of which 80% had performed ≥2,500 TIs. The overall TI success rate, first pass success rate, and airway complication rate were in all children (<16 years) 98%, 82%, and 12%. The corresponding rates among infants (<2 years) were 94%, 67%, and 11%. The median time on scene was 30 minutes.

Conclusion:

This study observed a high overall prehospital TI success rate in children with relatively few associated complications and short time on scene, despite the challenges presented by the pediatric prehospital TI.

Keywords

airway managementEmergency Medical Servicespediatricprehospitaltracheal intubation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 5 , October 2021 , pp. 547 - 552
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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