Advanced airway management in hoist and longline operations in mountain HEMS - considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

Pietsch, Urs; Knapp, Jürgen; Kreuzer, Oliver; Ney, Ludwig; Strapazzon, Giacomo; Lischke, Volker; Albrecht, Roland; Phillips, Patrick; Rauch, Simon (2018). Advanced airway management in hoist and longline operations in mountain HEMS - considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM). Scandinavian journal of trauma, resuscitation and emergency medicine, 26(1), p. 23. BioMed Central 10.1186/s13049-018-0490-5

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BACKGROUND Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS. Relevant reference lists were hand-searched. RESULTS Three articles with regard to advanced airway management and five articles concerning the epidemiology of advanced airway management in hoist or longline rescue missions were included. We found one case report regarding ventilation during hoist operations. The exact incidence of advanced airway management before evacuation of a patient by HEC is unknown but seems to be very low (< 5%). There are several hazards which can impede mechanical ventilation of patients during HEC extractions: loss of equipment, hyperventilation, inability to ventilate and consequent hypoxia, as well as inadequacy of monitoring. CONCLUSIONS Advanced airway management prior to HEC operation is rarely performed. If intubation before helicopter hoist operations (HHO) and human cargo sling (HCS) extraction is considered by the rescue team, a risk/benefit analysis should be performed and a clear standard operating procedure (SOP) should be defined. Continuous and rigorous training including the whole crew is required. An international registry on airway management during HEC extraction would be desirable.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Knapp, Jürgen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-7241

Publisher:

BioMed Central

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

25 Apr 2018 09:14

Last Modified:

22 Oct 2019 19:55

Publisher DOI:

10.1186/s13049-018-0490-5

PubMed ID:

29615073

Uncontrolled Keywords:

Airway management Helicopter emergency medical services Hoist Human external cargo Longline Prehospital emergency medicine Search and rescue

BORIS DOI:

10.7892/boris.114544

URI:

https://boris.unibe.ch/id/eprint/114544

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