Out-of-hospital pediatric airway management in the United States

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: The objective of this study was to characterize pediatric out-of-hospital airway management interventions, success rates, and complications in the United States using the 2012 National Emergency Medical Services Information System (NEMSIS) dataset. Methods: In 2012, NEMSIS collected data from Emergency Medical Services (EMS) encounters in 40 states. We included all patients less than 18 years of age and identified all patients who had airway interventions including endotracheal intubation (ETI), bag-valve-mask ventilation (BVM), continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP) and alternate airways (Combitube, King LT, Laryngeal Mask Airway (LMA), esophageal obturator airway, and cricothyroidotomy). Success and complication rates were analyzed and compared across pediatric age groups, by race, ethnicity, clinical condition, and geographic region. Results: We identified a total of 949,301 pediatric patient care events in the NEMSIS 2012 dataset. 4.5% had airway management procedures (42,936 events). Invasive airway management or ventilation (ETI, cricothyroidotomy, alternate airway, CPAP/BiPAP, BVM and other ventilation) took place in 1.5% of patient care events (14,107). Of those who had invasive airway management, 29.9% were less than 1 year of age, 58.1% were male, 42.3% were white, and 83.6% were in urban areas. ETI occurred in 3124 of patient care events (329 per 100,000; 95% CI 318-341). Overall success of ETI was 81.1% (95% CI 79.7-82.6). Lower success was noted in patients with cardiac arrest (75.5%, 95% CI 72.6-78.3) and those aged 1-12 months (72.1%, 95% CI 68.3-75.6). Conclusions: Out-of-hospital pediatric advanced airway procedures were infrequently performed. Success rates are lowest in patients aged 1-12 months.

Original languageEnglish (US)
Pages (from-to)104-110
Number of pages7
JournalResuscitation
Volume90
DOIs
StatePublished - May 1 2015

Fingerprint

Pediatric Hospitals
Airway Management
Intratracheal Intubation
Emergency Medical Services
Information Systems
Patient Care
Continuous Positive Airway Pressure
Masks
Ventilation
Pediatrics
Pressure
Laryngeal Masks
Heart Arrest
Age Groups
Datasets

Keywords

  • Intubation
  • Out-of-hospital airway management
  • Pediatric airway management
  • Pediatric out-of-hospital care
  • Pediatric prehospital care
  • Supraglottic device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Out-of-hospital pediatric airway management in the United States. / Hansen, Matthew; Lambert, William; Guise, Jeanne-Marie; Warden, Craig; Mann, N. Clay; Wang, Henry.

In: Resuscitation, Vol. 90, 01.05.2015, p. 104-110.

Research output: Contribution to journalArticle

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title = "Out-of-hospital pediatric airway management in the United States",
abstract = "Objective: The objective of this study was to characterize pediatric out-of-hospital airway management interventions, success rates, and complications in the United States using the 2012 National Emergency Medical Services Information System (NEMSIS) dataset. Methods: In 2012, NEMSIS collected data from Emergency Medical Services (EMS) encounters in 40 states. We included all patients less than 18 years of age and identified all patients who had airway interventions including endotracheal intubation (ETI), bag-valve-mask ventilation (BVM), continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP) and alternate airways (Combitube, King LT, Laryngeal Mask Airway (LMA), esophageal obturator airway, and cricothyroidotomy). Success and complication rates were analyzed and compared across pediatric age groups, by race, ethnicity, clinical condition, and geographic region. Results: We identified a total of 949,301 pediatric patient care events in the NEMSIS 2012 dataset. 4.5{\%} had airway management procedures (42,936 events). Invasive airway management or ventilation (ETI, cricothyroidotomy, alternate airway, CPAP/BiPAP, BVM and other ventilation) took place in 1.5{\%} of patient care events (14,107). Of those who had invasive airway management, 29.9{\%} were less than 1 year of age, 58.1{\%} were male, 42.3{\%} were white, and 83.6{\%} were in urban areas. ETI occurred in 3124 of patient care events (329 per 100,000; 95{\%} CI 318-341). Overall success of ETI was 81.1{\%} (95{\%} CI 79.7-82.6). Lower success was noted in patients with cardiac arrest (75.5{\%}, 95{\%} CI 72.6-78.3) and those aged 1-12 months (72.1{\%}, 95{\%} CI 68.3-75.6). Conclusions: Out-of-hospital pediatric advanced airway procedures were infrequently performed. Success rates are lowest in patients aged 1-12 months.",
keywords = "Intubation, Out-of-hospital airway management, Pediatric airway management, Pediatric out-of-hospital care, Pediatric prehospital care, Supraglottic device",
author = "Matthew Hansen and William Lambert and Jeanne-Marie Guise and Craig Warden and Mann, {N. Clay} and Henry Wang",
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AU - Hansen, Matthew

AU - Lambert, William

AU - Guise, Jeanne-Marie

AU - Warden, Craig

AU - Mann, N. Clay

AU - Wang, Henry

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objective: The objective of this study was to characterize pediatric out-of-hospital airway management interventions, success rates, and complications in the United States using the 2012 National Emergency Medical Services Information System (NEMSIS) dataset. Methods: In 2012, NEMSIS collected data from Emergency Medical Services (EMS) encounters in 40 states. We included all patients less than 18 years of age and identified all patients who had airway interventions including endotracheal intubation (ETI), bag-valve-mask ventilation (BVM), continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP) and alternate airways (Combitube, King LT, Laryngeal Mask Airway (LMA), esophageal obturator airway, and cricothyroidotomy). Success and complication rates were analyzed and compared across pediatric age groups, by race, ethnicity, clinical condition, and geographic region. Results: We identified a total of 949,301 pediatric patient care events in the NEMSIS 2012 dataset. 4.5% had airway management procedures (42,936 events). Invasive airway management or ventilation (ETI, cricothyroidotomy, alternate airway, CPAP/BiPAP, BVM and other ventilation) took place in 1.5% of patient care events (14,107). Of those who had invasive airway management, 29.9% were less than 1 year of age, 58.1% were male, 42.3% were white, and 83.6% were in urban areas. ETI occurred in 3124 of patient care events (329 per 100,000; 95% CI 318-341). Overall success of ETI was 81.1% (95% CI 79.7-82.6). Lower success was noted in patients with cardiac arrest (75.5%, 95% CI 72.6-78.3) and those aged 1-12 months (72.1%, 95% CI 68.3-75.6). Conclusions: Out-of-hospital pediatric advanced airway procedures were infrequently performed. Success rates are lowest in patients aged 1-12 months.

AB - Objective: The objective of this study was to characterize pediatric out-of-hospital airway management interventions, success rates, and complications in the United States using the 2012 National Emergency Medical Services Information System (NEMSIS) dataset. Methods: In 2012, NEMSIS collected data from Emergency Medical Services (EMS) encounters in 40 states. We included all patients less than 18 years of age and identified all patients who had airway interventions including endotracheal intubation (ETI), bag-valve-mask ventilation (BVM), continuous positive airway pressure/bilevel positive airway pressure (CPAP/BiPAP) and alternate airways (Combitube, King LT, Laryngeal Mask Airway (LMA), esophageal obturator airway, and cricothyroidotomy). Success and complication rates were analyzed and compared across pediatric age groups, by race, ethnicity, clinical condition, and geographic region. Results: We identified a total of 949,301 pediatric patient care events in the NEMSIS 2012 dataset. 4.5% had airway management procedures (42,936 events). Invasive airway management or ventilation (ETI, cricothyroidotomy, alternate airway, CPAP/BiPAP, BVM and other ventilation) took place in 1.5% of patient care events (14,107). Of those who had invasive airway management, 29.9% were less than 1 year of age, 58.1% were male, 42.3% were white, and 83.6% were in urban areas. ETI occurred in 3124 of patient care events (329 per 100,000; 95% CI 318-341). Overall success of ETI was 81.1% (95% CI 79.7-82.6). Lower success was noted in patients with cardiac arrest (75.5%, 95% CI 72.6-78.3) and those aged 1-12 months (72.1%, 95% CI 68.3-75.6). Conclusions: Out-of-hospital pediatric advanced airway procedures were infrequently performed. Success rates are lowest in patients aged 1-12 months.

KW - Intubation

KW - Out-of-hospital airway management

KW - Pediatric airway management

KW - Pediatric out-of-hospital care

KW - Pediatric prehospital care

KW - Supraglottic device

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