One-year outcome after prehospital intubation

Area of Science:

• Emergency Medicine
• Critical Care
• Neurology

Background:

• Physician-staffed emergency medical services (EMS) augment prehospital care.
• Advanced airway management by EMS indicates patient severity.
• This study focuses on long-term outcomes of prehospital intubation by EMS physicians for critically ill patients (excluding cardiac arrest).

Purpose of the Study:

• To evaluate the long-term neurological outcome of critically ill patients intubated by EMS physicians in the prehospital setting.
• To assess survival rates and neurological recovery 1 year after prehospital advanced airway management.

Main Methods:

• Retrospective analysis of 483 patients intubated by EMS physicians between 2007-2011.
• Evaluation based on hospital records 1 year post-incident.
• Neurological outcome assessed using the modified Glasgow Outcome Score (GOS); time and cause of death recorded.

Main Results:

• 55.3% of patients achieved good neurological recovery (GOS 4-5) at 1 year.
• Overall 1-year mortality was 35.0%; 9.7% had poor neurological outcome (GOS 2-3).
• Patients with intoxication/convulsions had better survival; those with intracranial pathology had worse prognosis. 85% of survivors recovered well.

Conclusions:

• The majority of critically ill patients intubated prehospital by EMS physicians experience favorable neurological recovery at 1 year.
• Over 80% of all deaths occurred within the first 30 days post-incident.
• Prehospital intubation by EMS physicians is associated with significant long-term survival and recovery for critically ill patients.