Proportion and clinical characteristics of patients who received prehospital airway or respiratory management by physicians aboard helicopters in Japan: a nationwide descriptive analysis.

purposeHelicopter Emergency Medical Services (HEMS) provide rapid prehospital care for patients with severe trauma and acute medical conditions. Airway management (including tracheal intubation, placement of supraglottic airway [SGA] device, cricothyrotomy, and bag-valve-mask [BVM] ventilation) and respiratory management (including mechanical ventilation and thoracostomy) are critical strategies used in prehospital settings. Although data on airway or respiratory management in patients who were treated by HEMS teams that are staffed by physicians in Japan are limited, this study aimed to describe the proportion and clinical characteristics of such patients using a nationwide registry.

methodsWe conducted a nationwide cohort study with a retrospective design, analyzing data from the Japanese Society for Aeromedical Services Registry between April 2020 and March 2023. Patients who underwent prehospital airway or respiratory management were included in this study. Data regarding age, sex, diagnosis, cardiac arrest, type of telecommunication, and airway or respiratory management were also collected. Descriptive statistics were used for analyses.

resultsAmong 54,140 patients treated by HEMS, 7477 (13.8%) underwent airway or respiratory management. The median age of the patients was 69 years, and 67.8% were male. The most frequent age group was 60-79 years (42.7%), and trauma was the most common diagnosis (35.4%). The most common management was orotracheal intubation (8.7%), followed by BVM ventilation (2.3%), mechanical ventilation (1.9%), thoracostomy (performed either via needle or chest tube) (1.0%), and SGA device placement (0.2%).

conclusionThis nationwide study revealed that airway or respiratory management was required in 13.8% of HEMS patients in Japan, particularly among older adults and those with trauma.