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Feasibility of prehospital rapid sequence intubation in the cabin of an AW169 Helicopter

Feasibility of prehospital rapid sequence intubation in the cabin of an AW169 Helicopter
Feasibility of prehospital rapid sequence intubation in the cabin of an AW169 Helicopter
Objective
Prehospital rapid sequence intubation (RSI) is an important aspect of prehospital care for helicopter emergency medical services (HEMS). This study examines the feasibility of in-aircraft (aircraft on the ground) RSI in different simulated settings.

Methods
Using an AW169 aircraft cabin simulator at Air Ambulance Kent Surrey Sussex, 3 clinical scenarios were devised. All required RSI in a “can intubate, can ventilate” (easy variant) and a “can't intubate, can't ventilate” scenario (difficult variant). Doctor-paramedic HEMS teams were video recorded, and elapsed times for prespecified end points were analyzed.

Results
Endotracheal intubation (ETI) was achieved fastest outside the simulator for the easy variant (median = 231 seconds, interquartile range = 28 seconds). Time to ETI was not significantly longer for in-aircraft RSI compared with RSI outside the aircraft, both in the easy (p = .14) and difficult variant (p = .50). Wearing helmets with noise distraction did not impact the time to intubation when compared with standard in-aircraft RSI, both in the easy (p = .28) and difficult variant (p = .24).

Conclusion
In-aircraft, on-the-ground RSI had no significant impact on the time to successful completion of ETI. Future studies should prospectively examine in-cabin RSI and explore the possibilities of in-flight RSI in civilian HEMS services.
468-472
McHenry, Allan
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Curtis, Leigh
2b895196-101a-4740-baa1-1ecd3e2f8d85
ter Avest, Ewoud
c4c8a685-8778-4319-833c-925e8f17df06
Russell, Malcolm
992dfbfb-3578-4b2c-ae15-b3cf968df7ed
Halls, Amy
75f2a817-41cf-4283-8276-2088d7d27429
Mitchinson, Sophie
d169f44a-7220-44c0-8804-8664c2f0f1ec
Griggs, Joanne
a992eadd-dd43-4f2e-8ac5-64b3e9f3f825
Lyon, Richard
a119db0f-a88c-46dc-9c90-a20194e9f13d
McHenry, Allan
f9e5a3a3-d6af-43db-9c5f-6d4cf97293ec
Curtis, Leigh
2b895196-101a-4740-baa1-1ecd3e2f8d85
ter Avest, Ewoud
c4c8a685-8778-4319-833c-925e8f17df06
Russell, Malcolm
992dfbfb-3578-4b2c-ae15-b3cf968df7ed
Halls, Amy
75f2a817-41cf-4283-8276-2088d7d27429
Mitchinson, Sophie
d169f44a-7220-44c0-8804-8664c2f0f1ec
Griggs, Joanne
a992eadd-dd43-4f2e-8ac5-64b3e9f3f825
Lyon, Richard
a119db0f-a88c-46dc-9c90-a20194e9f13d

McHenry, Allan, Curtis, Leigh, ter Avest, Ewoud, Russell, Malcolm, Halls, Amy, Mitchinson, Sophie, Griggs, Joanne and Lyon, Richard (2020) Feasibility of prehospital rapid sequence intubation in the cabin of an AW169 Helicopter. Air Medical Journal, 39 (6), 468-472. (doi:10.1016/j.amj.2020.08.006).

Record type: Article

Abstract

Objective
Prehospital rapid sequence intubation (RSI) is an important aspect of prehospital care for helicopter emergency medical services (HEMS). This study examines the feasibility of in-aircraft (aircraft on the ground) RSI in different simulated settings.

Methods
Using an AW169 aircraft cabin simulator at Air Ambulance Kent Surrey Sussex, 3 clinical scenarios were devised. All required RSI in a “can intubate, can ventilate” (easy variant) and a “can't intubate, can't ventilate” scenario (difficult variant). Doctor-paramedic HEMS teams were video recorded, and elapsed times for prespecified end points were analyzed.

Results
Endotracheal intubation (ETI) was achieved fastest outside the simulator for the easy variant (median = 231 seconds, interquartile range = 28 seconds). Time to ETI was not significantly longer for in-aircraft RSI compared with RSI outside the aircraft, both in the easy (p = .14) and difficult variant (p = .50). Wearing helmets with noise distraction did not impact the time to intubation when compared with standard in-aircraft RSI, both in the easy (p = .28) and difficult variant (p = .24).

Conclusion
In-aircraft, on-the-ground RSI had no significant impact on the time to successful completion of ETI. Future studies should prospectively examine in-cabin RSI and explore the possibilities of in-flight RSI in civilian HEMS services.

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Accepted/In Press date: 1 January 2020
Published date: 1 November 2020

Identifiers

Local EPrints ID: 444884
URI: http://eprints.soton.ac.uk/id/eprint/444884
PURE UUID: eb17df01-9f30-4a4b-b12e-657dde6d1f36

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Date deposited: 09 Nov 2020 17:32
Last modified: 16 Mar 2024 09:46

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Contributors

Author: Allan McHenry
Author: Leigh Curtis
Author: Ewoud ter Avest
Author: Malcolm Russell
Author: Amy Halls
Author: Sophie Mitchinson
Author: Joanne Griggs
Author: Richard Lyon

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