Pre-hospital advanced airway management by
anaesthetist and nurse anaesthetist critical care
teams: a prospective observational study of 2028
pre-hospital tracheal intubations
Editors comments : A large Nordic study of prehospital intubations by physicians and nurses. What it adds is that its the expertise and skill of provider that matters, not whether nurse nor physician , as success rates similar. Also video laryngoscopy was associated with greater first pass success than direct laryngoscopy. We dont know if outcomes any better with prehospital intubation still but this study seeks to promote arguement that anaesthesia providers, either physicians or nurses , should be only ones to perform prehospital intubations as the complication rates and speed are similar to inhospital. They contrast this study with another international study AIRPORT, looking at anaesthesia providers as well as emergency physicians. The implied assumption is that anaesthesia providers do more intubations per annum than emergency physicians and so have better results. This Nordic study doesnt really address that as only 1.5% emergency physicians in study, due to fact that as a specialty its still very new in these countries. Also interestingly the speed of the prehospital RSI is argued to be a positive thing as complication rates are still low. and hence the use of shortened checklists and more expertly trained providers is implied to be superior. There is a lot of bias in this study as self reported and data is unverifiable.
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 