Evaluation of Prehospital Endotracheal Intubation in Pediatric Patients in a German Helicopter Emergency Medical Service: An Analysis of 920 Cases

A C T Management of the pediatric airway is a challenging procedure in prehospital emergency medicine.This retrospective study evaluates prehospital airway management in 920 pediatric patients in a German helicopter emergency medical service (HEMS) system from 2012 to 2021.Prehospital pediatric intubation was a rare event (0.2% of all missions).Good visualization of the glottis (Cormack-Lehane I or II) was possible in 96.3% of the intubations.The first-pass intubation success was 86.6%; all children could finally be intubated successfully.The use of muscle relaxants significantly improved first-pass success in prehospital emergency anesthesia (90.1% vs. 83.1%;P = .002).We recognized a low rate of the use of aids such as stylet, bougie, or video laryngoscopy.The use of video laryngoscopy increased over the years, but did not translate into a higher first-attempt success rate.When taking over children with an already managed airway, HEMS teams found tube malplacement in 8.4% of the cases in primary missions.In the analyzed data, pediatric airway management was on a comparable level with adult airway management.Nevertheless, room for improvement and a need for further studies were identified.