SynthesisCritical care (London, England)2011
Revisiting the value of pre-hospital tracheal intubation: an all time systematic literature review extracting the Utstein airway core variables.
Synthesis in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- [Systematic analysis of airway registries in emergency medicine].Der Anaesthesist · 2018Pooled it
- Does pre-hospital endotracheal intubation improve survival in adults with non-traumatic out-of-hospital cardiac arrest? A systematic review.The western journal of emergency medicine · 2014Pooled it
- Patient safety in pre-hospital emergency tracheal intubation: a comprehensive meta-analysis of the intubation success rates of EMS providers.Critical care (London, England) · 2012Pooled it
- Intubation first-pass success in a high performing pre-hospital critical care system is not associated with 30-day mortality: a registry study of 4496 intubation attempts.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- Pre-hospital emergency anaesthesia in trauma patients treated by anaesthesiologist and nurse anaesthetist staffed critical care teams.Acta anaesthesiologica Scandinavica · 2021Article
- A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study.International journal of emergency medicine · 2019Article
- Collecting core data in physician-staffed pre-hospital helicopter emergency medical services using a consensus-based template: international multicentre feasibility study in Finland and Norway.BMC health services research · 2019Observational
- Airway Management in the Emergency Department (The OcEAN-Study) - a prospective single centre observational cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Observational
- Standardised data reporting from pre-hospital advanced airway management - a nominal group technique update of the Utstein-style airway template.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Prehospital Intubation and Outcome in Traumatic Brain Injury-Assessing Intervention Efficacy in a Modern Trauma Cohort.Frontiers in neurology · 2018Article
- Hypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre study.BMC emergency medicine · 2017Observational
- In-hospital airway management training for non-anesthesiologist EMS physicians: a descriptive quality control study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Airway management by physician-staffed Helicopter Emergency Medical Services - a prospective, multicentre, observational study of 2,327 patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2015Observational
- Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia.Critical care (London, England) · 2015Article
- Prehospital endotracheal intubation: elemental or detrimental?Critical care (London, England) · 2015Review
- The process of prehospital airway management: challenges and solutions during paramedic endotracheal intubation.Critical care medicine · 2014Article
- Oxygenation, ventilation, and airway management in out-of-hospital cardiac arrest: a review.BioMed research international · 2014Review
- Developing templates for uniform data documentation and reporting in critical care using a modified nominal group technique.Scandinavian journal of trauma, resuscitation and emergency medicine · 2013Article
- Training and experience are more important than the type of practitioner for intubation success.Critical care (London, England) · 2013Article
- Reversal of succinylcholine induced apnea with an organophosphate scavenging recombinant butyrylcholinesterase.PloS one · 2013Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough tracheal intubation (TI) in the pre-hospital setting is regularly carried out by emergency medical service (EMS) providers throughout the world, its value is widely debated. Heterogeneity in procedures, providers, patients, systems and stated outcomes, and inconsistency in data reporting make scientific reports difficult to interpret and compare, and the majority are of limited quality. To hunt down what is really known about the value of pre-hospital TI, we determined the rate of reported Utstein airway variables (28 core variables and 12 fixed-system variables) found in current scientific publications on pre-hospital TI.
methodsWe performed an all time systematic search according to the PRISMA guidelines of Medline and EMBASE to identify original research pertaining to pre-hospital TI in adult patients.
resultsFrom 1,076 identified records, 73 original papers were selected. Information was extracted according to an Utstein template for data reporting from in-the-field advanced airway management. Fifty-nine studies were from North American EMS systems. Of these, 46 (78%) described services in which non-physicians conducted TI. In 12 of the 13 non-North American EMS systems, physicians performed the pre-hospital TI. Overall, two were randomised controlled trials (RCTs), and 65 were observational studies. None of the studies presented the complete set of recommended Utstein airway variables. The median number of core variables reported was 10 (max 21, min 2, IQR 8-12), and the median number of fixed system variables was 5 (max 11, min 0, IQR 4-8). Among the most frequently reported variables were "patient category" and "service mission type", reported in 86% and 71% of the studies, respectively. Among the least-reported variables were "co-morbidity" and "type of available ventilator", both reported in 2% and 1% of the studies, respectively.
conclusionsCore data required for proper interpretation of results were frequently not recorded and reported in studies investigating TI in adults. This makes it difficult to compare scientific reports, assess their validity, and extrapolate to other EMS systems. Pre-hospital TI is a complex intervention, and terminology and study design must be improved to substantiate future evidence based clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.