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Best practice advice on pre-hospital emergency anaesthesia & advanced airway management
Kate Crewdson1, David Lockey2, Wolfgang Voelckel2
1Norwegian Air Ambulance Foundation, Drøbak, Norway. katecrewdson@gmail.com.
Insights
Pre-hospital emergency anaesthesia (PHEA) and advanced airway management are critical for critically ill patients. This guidance outlines best practices for these complex interventions, emphasizing trained personnel and standardized equipment.
Area of Science:
- Emergency Medicine
- Critical Care
- Anesthesiology
Background:
- Effective airway management is crucial for critically ill and injured patients.
- Pre-hospital emergency anaesthesia (PHEA) and advanced airway management remain subjects of debate.
- Certain patients require urgent advanced airway interventions before hospital admission.
Purpose of the Study:
- To provide current best practice advice for PHEA and advanced airway management.
- To establish guidelines for the provision of pre-hospital advanced airway interventions.
- To address the controversial aspects of PHEA and advanced airway management.
Main Methods:
- Developed by the EHAC Medical Working Group with pre-hospital critical care experts.
- Utilized a nominal group technique to establish best practices.
- Guidelines were developed through online collaboration and iterative refinement over three meetings.
Main Results:
- The EHAC best practice advice encompasses all facets of PHEA and advanced airway management.
- Presents up-to-date evidence on current best practices in the field.
- Offers comprehensive guidance for pre-hospital airway interventions.
Conclusions:
- PHEA and advanced airway management are complex procedures requiring skilled professionals and standardized equipment.
- A well-rehearsed approach is essential for successful outcomes.
- If advanced airway interventions are not feasible, basic airway management must be diligently applied and monitored.
Background:
Effective and timely airway management is a priority for sick and injured patients. The benefit and conduct of pre-hospital emergency anaesthesia (PHEA) and advanced airway management remains controversial but there are a proportion of critically ill and injured patients who require urgent advanced airway management prior to hospital arrival. This document provides current best practice advice for the provision of PHEA and advanced airway management.
Method:
This best practice advice was developed from EHAC Medical Working Group enforced by pre-hospital critical care experts. The group used a nominal group technique to establish the current best practice for the provision of PHEA and advanced airway management. The group met on three separate occasions to discuss and develop the guideline. All members of the working party were able to access and edit the guideline online.
Results:
This EHAC best practice advice covers all areas of PHEA and advanced airway management and provides up to date evidence of current best practice.
Conclusion:
PHEA and advanced airway management are complex interventions that should be delivered by appropriately trained personnel using a well-rehearsed approach and standardised equipment. Where advanced airway interventions cannot be delivered, careful attention should be given to applying basic airway interventions and ensuring their effectiveness at all times.
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