Effectiveness of Manual Ventilation in Intubated Helicopter Emergency Services-Transported Trauma Patients

Brett McLachlan, Craig Bilbrey, Keith Mausner, Timothy J Lenz
Air Medical Journal 2019, 38 (4): 273-275

BACKGROUND: Helicopter Emergency Medical Services agencies frequently transport intubated patients to definitive care. No evidence exists to determine the type of ventilation in this population. Practice varies amongst programs from bag-valve-mask to mechanical ventilation.

STUDY OBJECTIVE: Evaluate the effectiveness of bag-valve ventilation in intubated trauma patients. We hypothesized manual ventilation provides adequate support to maintain physiologic ETCO2 .

METHODS: From June to December 2015, twenty patients were enrolled in this prospective, observational study. Included were endotracheally intubated trauma patients transported by this HEMS program. Excluded were interfacility transports, non-scene calls, and patients with supraglottic devices. ETCO2 was recorded every 30 seconds during the flight. As a descriptive pilot study, power was not considered.

RESULTS: 20 patients provided over 500 cumulative minutes of manual ventilation data. The percentage of cumulative time spent with adequate oxygen saturations was 83.6%. The percentage of cumulative time spent with adequate ETCO2 was 48.7%, with 34.6% of time spent under and 16.7% above this range.

CONCLUSION: Manual ventilation maintained a physiologic ETCO2 only 16.7% of the time. Significant variability existed, resulting in intermittent hypoxia and hyperventilation. Prior research linked such events to increased morbidity and mortality. Further studies are warranted to compare manual against mechanically ventilated patients.


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"