• C Slagt, A Zondervan, P Patka, and J J de Lange.
• Department of Anaesthesiology, General Hospital De Heel Zaans Medical Center, Zaandam, The Netherlands. slagt.c@deheel.nl
• Air Med. J. 2004 Sep 1;23(5):36-7.

IntroductionDifferent skilled personnel perform prehospital airway management, by far one of the most challenging skills with major consequences upon failure.SettingThe setting for this study was the helicopter emergency medical service at the Vrije Universiteit Medical Center, Amsterdam, the Netherlands.MethodsWe conducted a retrospective analysis of all medical charts of intubated trauma patients in the period from May 1995 to May 2000. We focused on intubation reasons and conditions.ResultsIn 43 of 653 patients (7%) the process of intubation was recorded as being difficult, leading to 5 failed intubations (11.6%). In 432 of 653 trauma victims (66%), general anaesthesia was required before intubation. Forty (9%) of these patients died, most soon after arrival in the hospital. The clinical condition of 221 (34%) patients was so poor that they did not require additional drugs for intubation; 73% of those patients died, with two-thirds dying at the accident site.ConclusionThe rate of difficult intubation in this analysis is low (7%). The overall airway failure (11.6%) is the same as seen in the literature when sedation and relaxation are used. An adult trauma victim with a Revised Trauma Score of 0 has a very poor prognosis of survival.

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