See the published version of this article at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
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Original research
Mechanical ventilation of patients in helicopter emergency medical service transport: An international survey.
Peter Hilbert-Carius
BG Klinikum Bergmannstrost Halle
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
Background: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature.
Method: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20-22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests.
Results: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0-25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21-100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p<0.01) and positive end-expiratory pressure (p=0.04) of the patients were significantly higher compared to first patient contact.
Conclusion: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS.
Trial Registration: The survey was prospectively registered at Research Registry (researchregistry2925).
Keywords
HEMS, mechanical ventilation, complications, quality, performance
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Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 18 Sep, 2020
Published
On 18 Nov, 2020
No community comments so far
Editorial decision: Accept
On 29 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Reviewers invited
Invitations sent on 27 Aug, 2020
Reviewer #1 agreed
On 27 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Review #1 received
Received 27 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 09 Aug, 2020
Editor invited
On 09 Aug, 2020
No comments provided
Editorial decision: Major Revision
On 23 Jul, 2020
Reviewer #2 agreed
On 14 Jul, 2020
Review #2 received
Received 14 Jul, 2020
Review #1 received
Received 09 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 01 Jun, 2020
Submission checks complete
On 31 May, 2020
Editor invited
On 31 May, 2020
First submitted
On 30 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original research
Mechanical ventilation of patients in helicopter emergency medical service transport: An international survey.
Peter Hilbert-Carius
BG Klinikum Bergmannstrost Halle
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 18 Sep, 2020
Published
On 18 Nov, 2020
No community comments so far
Editorial decision: Accept
On 29 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Reviewers invited
Invitations sent on 27 Aug, 2020
Reviewer #1 agreed
On 27 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Review #1 received
Received 27 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 09 Aug, 2020
Editor invited
On 09 Aug, 2020
No comments provided
Editorial decision: Major Revision
On 23 Jul, 2020
Reviewer #2 agreed
On 14 Jul, 2020
Review #2 received
Received 14 Jul, 2020
Review #1 received
Received 09 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 01 Jun, 2020
Submission checks complete
On 31 May, 2020
Editor invited
On 31 May, 2020
First submitted
On 30 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
Background: Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ventilation in HEMS are available in the literature.
Method: We conducted an international survey to evaluate mechanical ventilation infrastructure in HEMS and collect data of transported ventilated patients. From June 20-22, 2019, the participating HEMS bases were asked to provide data via a web-based platform. Vital parameters and ventilation settings of the patients at first patient contact and at handover were compared using non-parametric statistical tests.
Results: Out of 215 invited HEMS bases, 53 responded. Respondents were from Germany, Denmark, United Kingdom, Luxembourg, Austria and Switzerland. Of the HEMS bases, all teams were physician staffed, mainly anesthesiologists (79%), the majority were board certified (92.5%) and trained in intensive care medicine (89%) and had a median (range) experience in HEMS of 9 (0-25) years. HEMS may provide a high level of expertise in mechanical ventilation whereas the majority of ventilators are able to provide pressure controlled ventilation and continuous positive airway pressure modes (77%). Data of 30 ventilated patients with a median (range) age of 54 (21-100) years and 53% male gender were analyzed. Of these, 24 were primary missions and 6 interfacility transports. At handover, oxygen saturation (p<0.01) and positive end-expiratory pressure (p=0.04) of the patients were significantly higher compared to first patient contact.
Conclusion: In this survey, the management of ventilated HEMS-patients was not associated with ventilation related serious adverse events. Patient conditions, training of medical crew and different technical and environmental resources are likely to influence management. Further studies are necessary to assess safety and process quality of mechanical ventilation in HEMS.
Trial Registration: The survey was prospectively registered at Research Registry (researchregistry2925).