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Success and complications by team composition for prehospital paediatric intubation: a systematic review and

Alan A Garner1,2, Nicholas Bennett3, Andrew Weatherall4,5

  • 1CareFlight Australia, 4 Barden St, Northmead, NSW, 2152, Australia. alan.garner@careflight.org.

Critical Care (London, England)
|April 17, 2020
PubMed

Insights

Physician teams achieve higher success rates for prehospital paediatric intubation and fewer complications. Utilizing physician-led teams is recommended for critically ill children needing emergency airway management.

Area of Science:

  • Emergency Medicine
  • Pediatric Critical Care
  • Airway Management

Background:

  • Clinical team composition impacts prehospital paediatric intubation outcomes.
  • Success and complication rates vary significantly based on the team involved.

Purpose of the Study:

  • To systematically review and meta-analyze intubation success and complication rates.
  • To compare outcomes based on different prehospital clinical team compositions.

Main Methods:

  • Systematic review and random-effects meta-analysis of 40 studies.
  • Inclusion of interventional and observational studies on pediatric prehospital intubation.
  • Independent data extraction and risk of bias assessment by two reviewers.

Main Results:

  • Physician teams (with relaxants) achieved 99% overall success and 91% first-pass success.
  • Non-physician teams without relaxants had lower success (72%) and higher complications (39%).
  • Physician teams demonstrated significantly lower airway complication rates (10%) compared to non-physician teams.

Conclusions:

  • Physician teams yield superior intubation success and safety in pediatric prehospital settings.
  • Recommendations support the use of physician prehospital teams for pediatric intubation when feasible.
  • Optimizing team composition is crucial for improving emergency airway management in children.
Abstract

Keywords:
Airway managementChildComplicationsEmergency medical servicesIntubation

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