• Lawrence H Brown, Michael W Hubble, Denise A Wilfong, Attila Hertelendy, and Randall W Benner.
• Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, Australia. Lawrence.Brown@jcu.edu.au
• Air Med. J. 2011 May 1;30(3):140-8.

BackgroundAirway management is a key component of air medical care for seriously ill and injured patients. This meta-analysis of the prehospital airway management literature explored the pooled air-medical placement success rates for oral endotracheal intubation (OETI), including rapid sequence intubation (RSI) and drug-facilitated intubation (DFI), nasotracheal intubation (NTI), blind insertion airway devices (BIAD), and surgical cricothyrotomy (SCRIC).MethodsWe performed a systematic literature search for all English language articles reporting success rates for airway procedures performed in the prehospital setting. After identifying articles specific to the air-medical environment, pooled estimates of success rates for each airway technique were calculated using a random effects meta-analysis model.ResultsThirty-six unique studies, encompassing 4,574 procedures, reported airway management success rates in the air medical environment. The pooled estimates (95% CI) for intervention success across all clinicians and patients were: OETI (without RSI/DFI): 86.4% (81.2%-90.3%); DFI: 95.1% (84.1%-98.6%); RSI: 96.7% (94.8%-97.9%); NTI: 76.1% (71.9%-79.9%); BIAD: 94.0% (85.8%-97.6%); and SCRIC: 90.8% (80.6%-95.9%).ConclusionWe provide pooled estimates for airway management procedural success rates in the air medical setting. These data can be used by program managers and medical directors in determining the most appropriate airway management procedures to incorporate into their services and for benchmarking in quality improvement activities.Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

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