Flying Docs and Airways

Flying Doctor Minh Le Cong describes the profile and success rates of emergency endotracheal intubation conducted by the Queensland Royal Flying Doctor Service aeromedical retrieval team, comprising a doctor and flight nurse. It would be interesting to know how many more patients have been added to the registry since this was submitted. An important contribution to the literature in retrieval medicine.













Objective To describe the profile and success rates of emergency endotracheal intubation conducted by the Queensland Royal Flying Doctor Service aeromedical retrieval team comprising a doctor and flight nurse.


Method Each intubator completed a study questionnaire at the time of each intubation for indications, complications, overall success, drugs utilised and deployment of rescue airway devices/adjuncts.


Results 76 patients were intubated; 72 intubations were successful. None required surgical airway and three were managed with laryngeal mask airways; the remaining failure was managed with simple airway positioning for transport. There were two cardiac arrests during intubation. Thiopentone and suxamethonium were the predominant drugs used to facilitate intubation.


Conclusion Despite a low rate of endotracheal intubation, the high success rate was similar to other aeromedical organisations’ published airway data. This study demonstrates the utility of the laryngeal mask airway device in the retrieval and transport setting, in particular for managing a failed intubation.


Flying doctor emergency airway registry: a 3-year, prospective, observational study of endotracheal intubation by the Queensland Section of the Royal Flying Doctor Service of Australia
Emerg Med J. 2010 Sep 15. [Epub ahead of print]

Those interested in learning more about this registry, including how often capnography was used, more information about the asystolic arrests, and whether they tried a blind digital intubation, can check this link to a presentation about the registry.