In-flight oral endotracheal intubation

Area of Science:

• Emergency Medicine
• Aeromedical Services
• Critical Care

Background:

• Endotracheal intubation (ETI) is a critical procedure in emergency medical services (EMS).
• Assessing ETI success rates in various pre-hospital and in-hospital settings is crucial for patient care.
• Aeromedical services face unique challenges during in-flight procedures.

Purpose of the Study:

• To analyze the success rates of endotracheal intubation (ETI) performed by aeromedical emergency medical services (EMS) crews during flight.
• To compare in-flight ETI success rates with those achieved in hospital and trauma scene settings.

Main Methods:

• Retrospective review of patients undergoing flight crew ETI over a 3-year period.
• Classification of ETI attempts into in-flight, hospital (referring), and ground (trauma scene) settings.
• Analysis of success rates, patient demographics, and interventions across different settings.

Main Results:

• A total of 302 patients underwent ETI by flight crews, with an overall success rate of 96.4%.
• In-flight ETI success rate was 94.2%, comparable to hospital (96.8%) and ground (98.3%) settings (P = .22).
• No significant differences were observed in pediatric patient proportions or multiple intubation attempts across groups.

Conclusions:

• Endotracheal intubation (ETI) by aeromedical crews is highly successful in-flight.
• In-flight ETI success rates are statistically similar to those in hospital and trauma scene settings.
• The study supports the efficacy of in-flight ETI within the studied aeromedical service.