Air medical journal
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The purpose of this study is to descriptively review the air medical transport of geriatric patients within the provincial air medical program of Nova Scotia. ⋯ Air medical transport usually is associated with trauma transport of the younger patient. This program review demonstrates that one-third of adult air medical transports in this province are for patients older than 65 who are critically ill, though often with nontrauma conditions, and are associated with a high mortality rate. Air medical transport programs should have strategies, education, and protocols that reflect the unique pathophysiology of the elderly.
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Air medical journal · Jul 2002
Etomidate as a sole agent for endotracheal intubation in the prehospital air medical setting.
Etomidate is an anesthetic agent with rapid onset, short duration of action, a generally stable hemodynamic profile, and cerebroprotective effects. It is used in the hospital setting to facilitate emergency endotracheal intubation. This helicopter EMS used etomidate as an intubating agent without paralytics for 2 years. ⋯ Etomidate can be used to facilitate emergency endotracheal intubation in the prehospital air medical setting, with a success rate of 89%. At the doses used in the study, hemodynamic parameters remained stable, but intubation was difficult or unsuccessful in 27% of patients. Masseter muscle spasm, which may represent orofacial myoclonus or inadequate relaxation, is common in patients who cannot be intubated with etomidate. Etomidate is recommended as a sole agent for facilitating intubation only when rapid sequence intubation with paralysis is contraindicated or otherwise undesirable.
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The purpose of this study was to determine the impact of an airway education program (AEP) on prehospital intubation. ⋯ Establishment of an AEP resulted in an increase in NMB for intubation, a dramatic decrease in the use of NMB without sedation, and a decrease in cricothyrotomy rate. The rate of intubation failure in nonarrested patients was higher in those who received no medications or partial RSI compared with full RSI.