Preface: This retrospective study examined physician performed prehospital intubations between 2008 and 2012 in Scottish aeromedical transport system. Over 200 intubations were analyzed and 75% of the intubations were during inter facility transport and 25% at the scene. There was a 15% incidence of hypoxia and an 8% incidence of hypotension.
On multivariate analysis, a Cormack and Lehane grade 3 or 4 glottic view was the only predictor of oxygen desaturation. Complication rates were similar between emergency medicine–trained and anesthesia-trained physicians.
Comment: It would be interesting to see if prehospital use of video laryngoscopy (e.g., Glidescope intubation) would decrease the rate of hypoxia.
Reference:
Wimalasena YH et al. Comparison of factors associated with desaturation in prehospital emergency anaesthesia in primary and secondary retrievals. Emerg Med J 2014 Nov 12; [e-pub ahead of print].