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Area of Science:

  • Emergency Medicine
  • Airway Management
  • Obesity Research

Background:

  • Previous studies on obesity and difficult airway management yielded inconsistent results, primarily in hospital settings.
  • The impact of patient body weight on prehospital airway management success remains largely unexamined.
  • Patient weight is a readily identifiable factor that may predict airway intervention difficulties.

Purpose of the Study:

  • To evaluate the relationship between patient body weight and the success of prehospital airway management.
  • To determine if patient weight is a significant predictor of difficult airway interventions in an emergency medical services (EMS) context.

Main Methods:

  • Retrospective analysis of the 2020 ESO Data Collaborative dataset.
  • Inclusion of adult patients weighing over 30kg with attempted orotracheal intubation (OTI) or blind insertion airway device (BIAD) placement.
  • Logistic and linear regression models used to assess the influence of weight (dichotomized at 100kg) on OTI and BIAD success rates.

Main Results:

  • Analysis included 45,344 patients; 84.3% experienced cardiac arrest.
  • Weight greater than 100kg was linked to decreased OTI success (OR=0.64) but increased BIAD success (OR=1.31).
  • A negative trend in OTI success and a positive trend in BIAD success were observed with increasing body weight.

Conclusions:

  • Increasing patient weight negatively correlates with orotracheal intubation success in prehospital settings.
  • Blind insertion airway device placement shows a positive trend with increasing patient weight.
  • Patient weight serves as an identifiable predictor for difficult oral intubation, informing airway management strategy selection.