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Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey
BACKGROUND: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature. METHOD: We conducted an inte...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672415/ https://www.ncbi.nlm.nih.gov/pubmed/33208195 http://dx.doi.org/10.1186/s13049-020-00801-1 |
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author | Hilbert-Carius, Peter Struck, Manuel F. Hofer, Veronika Hinkelbein, Jochen Rognås, Leif Adler, Jörn Christian, Michael D. Wurmb, Thomas Bernhard, Michael Hossfeld, Björn |
author_facet | Hilbert-Carius, Peter Struck, Manuel F. Hofer, Veronika Hinkelbein, Jochen Rognås, Leif Adler, Jörn Christian, Michael D. Wurmb, Thomas Bernhard, Michael Hossfeld, Björn |
author_sort | Hilbert-Carius, Peter |
collection | PubMed |
description | BACKGROUND: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature. METHOD: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20–22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests. RESULTS: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0–25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21–100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p < 0.01) and positive end-expiratory pressure (p = 0.04) of the patients were significantly higher compared to first patient contact. CONCLUSION: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS. TRIAL REGISTRATION: The survey was prospectively registered at Research Registry (researchregistry2925). |
format | Online Article Text |
id | pubmed-7672415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76724152020-11-18 Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey Hilbert-Carius, Peter Struck, Manuel F. Hofer, Veronika Hinkelbein, Jochen Rognås, Leif Adler, Jörn Christian, Michael D. Wurmb, Thomas Bernhard, Michael Hossfeld, Björn Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature. METHOD: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20–22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests. RESULTS: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0–25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21–100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p < 0.01) and positive end-expiratory pressure (p = 0.04) of the patients were significantly higher compared to first patient contact. CONCLUSION: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS. TRIAL REGISTRATION: The survey was prospectively registered at Research Registry (researchregistry2925). BioMed Central 2020-11-18 /pmc/articles/PMC7672415/ /pubmed/33208195 http://dx.doi.org/10.1186/s13049-020-00801-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Original Research Hilbert-Carius, Peter Struck, Manuel F. Hofer, Veronika Hinkelbein, Jochen Rognås, Leif Adler, Jörn Christian, Michael D. Wurmb, Thomas Bernhard, Michael Hossfeld, Björn Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title | Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title_full | Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title_fullStr | Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title_full_unstemmed | Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title_short | Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
title_sort | mechanical ventilation of patients in helicopter emergency medical service transport: an international survey |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7672415/ https://www.ncbi.nlm.nih.gov/pubmed/33208195 http://dx.doi.org/10.1186/s13049-020-00801-1 |
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