A study assessing critical care transport (CCT) crews’ success rates with managing the airways of patients while enroute to the hospital by air or ground ambulance has revealed that those rates were favorable, and, more importantly, were similar to findings reported in acute-care hospital settings. Results of the study, which was fully funded by a MedEvac Foundation International grant, are published in the July/September 2010 edition of Prehospital Emergency Care (PEC).

Titled “Airway Management Success and Hypoxemia Rates in Air and Ground Critical care Transport: A Prospective Multicenter Study,” the study monitored endotracheal intubation (ETI) attempts, success rates and peri-ETI oxygenation by crews from 11 CCT programs on 603 patients between July 2007 and December 2008. Of those cases, 582 patients (96.5 percent) had successful ETI rates, while new hypoxemia (respiratory distress resulting from abnormally low oxygen levels in the blood during or after the ETI) rarely occurred, and was present in only six (1.6 percent) of the cases that necessitated continuous monitoring for it. Moreover, ETI success was 96.2 percent among the 182 cases that had failed ETI attempts before the arrival of CCT crews, and was, further, just as high as in patients that had had no pre-CCT ET attempts.

The findings of this study are significant because they challenge previous reports that have suggested prehospital ETI is associated with greater negative patient outcomes, according to Stephen Thomas, MD, MPH, a lead author of the study. “We truly believe that our demonstration of airway management success rates that are comparable to those in hospitals shows the helicopter EMS world is performing at an exceedingly high level in terms of patient care and quality,” said Dr. Thomas. “Furthermore, the physiologic outcomes addressed in this [airway] study reveal that the high success rates for critical care transport team airway management are matched by a patient safety focus that is best demonstrated through a lack of respiratory degradation or distress during intubation.”

MedEvac Foundation International Chair Kevin Hutton, MD, FACEP, agreed. “ETI has long been a controversial component of pre-hospital care, and that is one of the reasons the Foundation chose to support this study,” said Dr. Hutton. “This [research] is worthwhile because it fulfills the longstanding need for EMS systems to more closely monitor and document ETI success and complication rates. Moreover, the study’s findings confirm that CCT crews, who receive greater training and use more sophisticated equipment and medications than ground EMS crews, are offering a higher level of care in these life-saving situations.”

About MedEvac Foundation International
MedEvac Foundation International is a 501(c)(3) charitable and research organization created by the Association of Air Medical Services (AAMS). The MedEvac Foundation International is the first organization of its kind to engage, mobilize and empower people and organizations to make a difference in medical transport worldwide. Through research, education, outreach, and charitable services, we seek to improve the safety, quality and delivery of medical transportation for patients everywhere.