One-year Outcome After Prehospital Intubation
Conditions
Keywords
Prehospital emergency care (MeSH), Emergency medical services (MeSH), Helicopter emergency medical service, Critical care (MeSH), Airway management (MeSH), Endotracheal intubation (MeSH), Patient outcome
Brief summary
The primary aim of this study was to describe the long-term outcome of critically ill or severely injured patients not in cardiac arrest treated by an EMS physician.
Detailed description
The aim of helicopter emergency medical services (HEMS) is to supplement ground EMS units in the care of prehospital patients. The need for advanced airway management in critical out-of-hospital patients can be considered as one indicator of the severity of the patient's condition. A recent European initiative suggested advanced airway management to be included in the top five research priorities for physician-provided prehospital care.To our knowledge, no previous studies describe the long-term outcome of critical prehospital patients treated by an EMS physician. The primary aim of this study was to describe the long-term outcome of critically ill or severely injured patients not in cardiac arrest treated by an EMS physician. Our secondary aims were to determine the indications and causes for EMS physician performed prehospital endotracheal intubation.
Interventions
PROCEDUREIntubation
HEMS physician prehospital intubation
Sponsors
Tampere University Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All non-cardiac arrest patients.
Exclusion criteria
* Patients with a known need for personal assistance in activities of daily life prior to the incident leading to prehospital intubation (outcome evaluation). * Patients intubated by EMS before HEMS arrival. * Death on scene or during transportation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mortality | 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Glasgow Outcome Score (GOS) | 1 year | GOS 1 = Death GOS 2 = Poor neurological outcome GOS 3 = Good neurological outcome Modified from the original 5 - step classification. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| HEMS Treated Patients Patients whose airways were secured by the HEMS physician.
Intubation: HEMS physician prehospital intubation | 483 |
| Total | 483 |
Baseline characteristics
| Characteristic | HEMS Treated Patients |
|---|---|
| Age, Continuous | 47.8 years |
| Gender Female | 164 Participants |
| Gender Male | 319 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Primary
Mortality
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| HEMS Treated Patients | Mortality | 35 percentage of one year mortality |
Secondary
Glasgow Outcome Score (GOS)
GOS 1 = Death GOS 2 = Poor neurological outcome GOS 3 = Good neurological outcome Modified from the original 5 - step classification.
Time frame: 1 year
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| HEMS Treated Patients | Glasgow Outcome Score (GOS) | 55 percentage of good neurological outcome |