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Advanced Airway Management – a Medical Emergency Response Team Perspective
  1. Maj Andrew Haldane, RAMC, Specialty Registrar in Anaesthesia1
  1. 1Selly Oak Hospital, Birmingham
  1. University Hospitals Birmingham NHS Trust, Edgbaston, Birmingham, B15 2TH 07958 739 437 aghaldane1{at}


Objectives To determine the number of medical emergency response team (MERT) patients undergoing advanced airway management in the peri-evacuation phase and to determine the indications for airway interventions undertaken in flight.

Methods This was a retrospective study. Data was collected frompatient report andmission debrief forms completed after each MERT mission during Operation HERRICK 10 (April-October 2009). All patients that received advanced airway interventions before or during evacuation were identified.

Results MERTs were involved in the primary transfer of 534 patients during the period studied, 56 (10.5%) underwent advanced airway management, of which 31 (5.8% of total) were initiated by the MERT in the peri-evacuation phase. Twenty five cases (4.7%) underwent advanced airway management by other pre-hospital providers prior to MERT arrival. Of the 31 advanced airway interventions undertaken in-flight, cardiac arrest was the primary indication in only nine cases.

Conclusions The figure of 56 patients requiring advanced airway management is at the higher end of the range expected from the study of historicalmilitary data. Thismay reflect the doctrine of “intelligent tasking”, that is sending this physician-led teamto themost seriously injured casualties.

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