Evaluation of prehospital airway-management in pediatric patients in a german helicopter emergency medical service - an analysis of 2642 cases

Management of the pediatric airway is a challenging procedure in prehospital emergency medicine. This retrospective study evaluates the management of the pediatric airway in 2,642 patients in a German HEMS service from 2012 to 2021. The first pass intubation success was 86,5%. 99,9% of all children could finally be successfully intubated. Use of muscle relaxants significantly improved first-pass-success. When taking over children with an already managed airway, HEMS teams found tube malplacement in 6% of the cases. Room for improvement was the low rate of used aids as stylet or video laryngoscopy. For patient safety a focused training as well as the implementation of a robust governance system should be implemented. Also, a structured approach for takeover should be trained and implemented.