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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2018

Open Access 01-12-2018 | Review

Advanced airway management in hoist and longline operations in mountain HEMS – considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Authors: Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2018

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Abstract

Background

Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations.

Methods

We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS. Relevant reference lists were hand-searched.

Results

Three articles with regard to advanced airway management and five articles concerning the epidemiology of advanced airway management in hoist or longline rescue missions were included. We found one case report regarding ventilation during hoist operations.
The exact incidence of advanced airway management before evacuation of a patient by HEC is unknown but seems to be very low (< 5%). There are several hazards which can impede mechanical ventilation of patients during HEC extractions: loss of equipment, hyperventilation, inability to ventilate and consequent hypoxia, as well as inadequacy of monitoring.

Conclusions

Advanced airway management prior to HEC operation is rarely performed. If intubation before helicopter hoist operations (HHO) and human cargo sling (HCS) extraction is considered by the rescue team, a risk/benefit analysis should be performed and a clear standard operating procedure (SOP) should be defined. Continuous and rigorous training including the whole crew is required. An international registry on airway management during HEC extraction would be desirable.
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Metadata
Title
Advanced airway management in hoist and longline operations in mountain HEMS – considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)
Authors
Urs Pietsch
Jürgen Knapp
Oliver Kreuzer
Ludwig Ney
Giacomo Strapazzon
Volker Lischke
Roland Albrecht
Patrick Phillips
Simon Rauch
Publication date
01-12-2018
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-018-0490-5

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