Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025
Airway management analysis in the rescue environment of the emergency service Zug: a retrospective real-world evaluation.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06653166 (Retrospektive Analyse Von Patientendaten bezüglich Die notfallmässige Atemwegssicherungen Durch Den Rettungsdienst Zug), which is not on this map. Not yet cited in PubMed.
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Retrospektive Analyse Von Patientendaten bezüglich Die notfallmässige Atemwegssicherungen Durch Den Rettungsdienst Zug (Airway Management Analysis in the Rescue Environment of the Emergency Service Zug) - Retrospective Analysis of Patient Data Regarding the Emergency Airway Management by the Rescue Service Zug
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAirway management is critical in prehospital care. This study quantified first pass success (FPS) for endotracheal intubation (ETI) in a Swiss emergency medical service (EMS) and identified factors associated with success.
methodsAll adult (≥ 18 years) ETI attempts documented in the EMS database between 1 January 2021 and 31 December 2024 were reviewed. Devices [direct laryngoscopy, standard-geometry videolaryngoscope (VL), hyperangulated VL], adjuncts [bougie, stylet], operators [critical-care paramedic (CCP), emergency physician (EP)] and setting were analyzed. The primary outcome was FPS; predictors were evaluated with univariate and multivariable logistic regression.
resultsETI was attempted in 270 patients (mean age 67.9 ± 16.4 year; 64.8% male); 55.6% intubations occurred during cardiopulmonary resuscitation. Overall FPS was 92.6% (250/270). Bougie use achieved 100% (49/49) FPS versus 91.0% (201/221) with a stylet (p = 0.03). Device-specific FPS was 94.3% (33/35, direct laryngoscopy), 94.0% (173/184, standard-geometry VL) and 86.3% (44/51, D-BLADE VL). FPS was significantly associated with D-BLADE VL use in patients with an anticipated difficult intubation (89,7% FPS, p < 0.001). CCP showed higher odds for FPS for CCP compared to EP (OR 3.61, 95% CI 1.14 to 11.45).
conclusionsBougie-assisted laryngoscopy was significantly associated with higher first pass success rates. When a difficult airway was anticipated, the hyperangulated D-BLADE videolaryngoscope showed higher odds for first pass success. Critical-care paramedics achieved first pass success rates comparable to those of emergency physicians.
trial registrationClinical Trials.gov: NCT06653166 (19 October 2024).
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