Evidence map›Paper›PMID 34794777›Full record

ArticleAir medical journal

Feasibility of Prehospital Emergency Anesthesia in the Cabin of an AW169 Helicopter Wearing Personal Protective Equipment During Coronavirus Disease 2019.

Kat Hunter, Allan S McHenry, Leigh Curtis, Ewoud Ter Avest, Sophie Mitchinson, Joanne E Griggs, Richard M Lyon, Air Ambulance Kent Surrey Sussex

Open access · hybridAbstract read
In one paragraph

Article in Air medical journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 40% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Kat HunterAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom.
Allan S McHenryAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom.
Leigh CurtisAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom.
Ewoud Ter AvestAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom; Department of Emergency Medicine, University Medical Center Groningen, Groningen, The Netherlands.
Sophie MitchinsonAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom.
Joanne E GriggsAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom; University of Surrey, Guildford, United Kingdom. Electronic address: JoG@aakss.org.uk.
Richard M LyonAir Ambulance Kent Surrey Sussex, Redhill, Surrey, United Kingdom; University of Surrey, Guildford, United Kingdom.
Air Ambulance Kent Surrey Sussex
University of Surrey · GBUniversity Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePrehospital emergency anesthesia in the form of rapid sequence intubation (RSI) is a critical intervention delivered by advanced prehospital critical care teams. Our previous simulation study determined the feasibility of in-aircraft RSI. We now examine whether this feasibility is preserved in a simulated setting when clinicians wear personal protective equipment (PPE) for aerosol-generating procedures (AGPs) for in-aircraft, on-the-ground RSI.

methodsAir Ambulance Kent Surrey Sussex is a helicopter emergency medical service that uses an AW169 cabin simulator. Wearing full AGP PPE (eye protection, FFP3 mask, gown, and gloves), 10 doctor-paramedic teams performed RSI in a standard "can intubate, can ventilate" scenario and a "can't intubate, can't oxygenate" (CICO) scenario. Prespecified timings were reported, and participant feedback was sought by questionnaire.

resultsRSI was most commonly performed by direct laryngoscopy and was successfully achieved in all scenarios. The time to completed endotracheal intubation (ETI) was fastest (287 seconds) in the standard scenario and slower (370 seconds, P = .01) in the CICO scenario. The time to ETI was not significantly delayed by wearing PPE in the standard (P = .19) or CICO variant (P = .97). Communication challenges, equipment complications, and PPE difficulties were reported, but ways to mitigate these were also reported.

conclusionIn-aircraft RSI (aircraft on the ground) while wearing PPE for AGPs had no significant impact on the time to successful completion of ETI in a simulated setting. Patient safety is paramount in civilian helicopter emergency medical services, but the adoption of in-aircraft RSI could confer significant patient benefit in terms of prehospital time savings, and further research is warranted.

Indexed as

AnesthesiaCOVID-19Emergency Medical ServicesAircraftFeasibility StudiesHumansIntubation, IntratrachealPersonal Protective EquipmentSARS-CoV-2

Identifiers

PMID34794777
PMCPMC8382585
OpenAlexW3193553881

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.