Cargando…

Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service

INTRODUCTION: We report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions. MATERIALS AND METHODS: Anaesthesiolog...

Descripción completa

Detalles Bibliográficos
Autores principales: Rognås, Leif, Hansen, Troels Martin, Kirkegaard, Hans, Tønnesen, Else
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176298/
https://www.ncbi.nlm.nih.gov/pubmed/24160909
http://dx.doi.org/10.1186/1757-7241-21-75
_version_ 1782336604916940800
author Rognås, Leif
Hansen, Troels Martin
Kirkegaard, Hans
Tønnesen, Else
author_facet Rognås, Leif
Hansen, Troels Martin
Kirkegaard, Hans
Tønnesen, Else
author_sort Rognås, Leif
collection PubMed
description INTRODUCTION: We report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions. MATERIALS AND METHODS: Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) registered data from February 1(st) 2011 to October 31(st) 2012. Included were patients of all ages for whom pre-hospital advanced airway management were considered but not performed. The main objectives were to investigate (1) the pre-hospital critical care anaesthesiologists’ reasons for considering performing pre-hospital advanced airway management in this group of patients (2) the pre-hospital critical care anaesthesiologists’ reasons for not performing pre-hospital advanced airway management (3) the methods used to treat these patients (4) the incidence of complications related to pre-hospital advanced airway management not being performed. RESULTS: We registered data from 1081 cases in which the pre-hospital critical care anaesthesiologists’ considered performing pre-hospital advanced airway management. The anaesthesiologists decided to withhold pre-hospital advanced airway management in 32.1% of these cases (n = 347). In 75.1% of these cases (n = 257) pre-hospital advanced airway management were withheld because of the patient’s condition and in 30.8% (n = 107) because of patient co-morbidity. The most frequently used alternative treatment was bag-mask ventilation, used in 82.7% of the cases (n = 287). Immediate complications related to the decision of not performing pre-hospital advanced airway management occurred in 0.6% of the cases (n = 2). CONCLUSION: We have illustrated the complexity of the critical decision-making associated with pre-hospital advanced airway management. This study is the first to identify the most common reasons why pre-hospital critical care anaesthesiologists sometimes choose to abstain from pre-hospital advanced airway management as well as the alternative treatment methods used.
format Online
Article
Text
id pubmed-4176298
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-41762982014-09-27 Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service Rognås, Leif Hansen, Troels Martin Kirkegaard, Hans Tønnesen, Else Scand J Trauma Resusc Emerg Med Original Research INTRODUCTION: We report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions. MATERIALS AND METHODS: Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) registered data from February 1(st) 2011 to October 31(st) 2012. Included were patients of all ages for whom pre-hospital advanced airway management were considered but not performed. The main objectives were to investigate (1) the pre-hospital critical care anaesthesiologists’ reasons for considering performing pre-hospital advanced airway management in this group of patients (2) the pre-hospital critical care anaesthesiologists’ reasons for not performing pre-hospital advanced airway management (3) the methods used to treat these patients (4) the incidence of complications related to pre-hospital advanced airway management not being performed. RESULTS: We registered data from 1081 cases in which the pre-hospital critical care anaesthesiologists’ considered performing pre-hospital advanced airway management. The anaesthesiologists decided to withhold pre-hospital advanced airway management in 32.1% of these cases (n = 347). In 75.1% of these cases (n = 257) pre-hospital advanced airway management were withheld because of the patient’s condition and in 30.8% (n = 107) because of patient co-morbidity. The most frequently used alternative treatment was bag-mask ventilation, used in 82.7% of the cases (n = 287). Immediate complications related to the decision of not performing pre-hospital advanced airway management occurred in 0.6% of the cases (n = 2). CONCLUSION: We have illustrated the complexity of the critical decision-making associated with pre-hospital advanced airway management. This study is the first to identify the most common reasons why pre-hospital critical care anaesthesiologists sometimes choose to abstain from pre-hospital advanced airway management as well as the alternative treatment methods used. BioMed Central 2013-10-25 /pmc/articles/PMC4176298/ /pubmed/24160909 http://dx.doi.org/10.1186/1757-7241-21-75 Text en Copyright © 2013 Rognås et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Rognås, Leif
Hansen, Troels Martin
Kirkegaard, Hans
Tønnesen, Else
Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title_full Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title_fullStr Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title_full_unstemmed Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title_short Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
title_sort refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176298/
https://www.ncbi.nlm.nih.gov/pubmed/24160909
http://dx.doi.org/10.1186/1757-7241-21-75
work_keys_str_mv AT rognasleif refrainingfromprehospitaladvancedairwaymanagementaprospectiveobservationalstudyofcriticaldecisionmakinginananaesthesiologiststaffedprehospitalcriticalcareservice
AT hansentroelsmartin refrainingfromprehospitaladvancedairwaymanagementaprospectiveobservationalstudyofcriticaldecisionmakinginananaesthesiologiststaffedprehospitalcriticalcareservice
AT kirkegaardhans refrainingfromprehospitaladvancedairwaymanagementaprospectiveobservationalstudyofcriticaldecisionmakinginananaesthesiologiststaffedprehospitalcriticalcareservice
AT tønnesenelse refrainingfromprehospitaladvancedairwaymanagementaprospectiveobservationalstudyofcriticaldecisionmakinginananaesthesiologiststaffedprehospitalcriticalcareservice