Hatton D, Sheets C. Surgical cricothyrotomy performed by air ambulance flight nurses: a 5‐year experience. J Emerg Med. 1993; 11:41–45.56 56 Gerich TG, Schmidt U, Hubrich V, Lobenhoffer HP, Tscherne H. Prehospital airway management in the acutely injured patient: the role of surgical cricothyrotomy revisited. J Trauma. 1998; 45:312–14.
57 57 Xeropotamos NS, Coats TJ, Wilson AW. Prehospital surgical airway management: 1 year's experience from the helicopter emergency medical service. Injury. 1993; 24:222–4.
58 58 Carlson JN, Karns C, Mann NC, et al. Procedures performed by emergency medical services in the United States. Prehosp Emerg Care. Published ahead of print August 13, 2015.
59 59 Spoerel WE, Narayanan PS, Singh NP. Transtracheal ventilation. Br J Anaesth. 1971; 43:932–9.
60 60 Jacobs HB, Smyth NP, Witorsch P. Transtracheal catheter ventilation: clinical experience in 36 patients. Chest. 1974; 65:36–40.
61 61 Yealy DM, Stewart RD, Kaplan RM. Myths and pitfalls in emergency translaryngeal ventilation: correcting misimpressions. Ann Emerg Med. 1988; 17:690–2.
62 62 Yealy DM, Stewart RD, Kaplan RM. Clarifications on translaryngeal ventilation. Ann Emerg Med. 1988; 17:1130.
63 63 Yealy DM, Plewa MC, Reed JJ, Kaplan RM, Ilkhanipour K, Stewart RD. Manual translaryngeal jet ventilation and the risk of aspiration in a canine model. Ann Emerg Med. 1990; 19:1238–41.
64 64 O'Connor RE, Swor RA. Verification of endotracheal tube placement following intubation. National Association of EMS Physicians Standards and Clinical Practice Committee. Prehosp Emerg Care. 1999; 3:248–50.
65 65 Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med. 2001; 37:32–37.
66 66 Jemmett ME, Kendal KM, Fourre MW, Burton JH. Unrecognized misplacement of endotracheal tubes in a mixed urban to rural emergency medical services setting. Acad Emerg Med. 2003; 10:961–5.
67 67 Wang HE, Kupas DF, Paris PM, Bates RR, Yealy DM. Preliminary experience with a prospective, multi‐centered evaluation of out‐of‐hospital endotracheal intubation. Resuscitation. 2003; 58:49–58.
68 68 Jones JH, Murphy MP, Dickson RL, Somerville GG, Brizendine EJ. Emergency physician‐verified out‐of‐hospital intubation: miss rates by paramedics. Acad Emerg Med. 2004; 11:707–709.
69 69 Jaffe MB. Mainstream or Sidestream Capnography? (white paper). 2002. http://oem.respironics.com/Downloads/Main%20vs%20Side.pdf. Accessed September 10, 2020.
70 70 Kelly JJ, Eynon CA, Kaplan JL, de Garavilla L, Dalsey WC. Use of tube condensation as an indicator of endotracheal tube placement. Ann Emerg Med. 1998; 31:575–8.
71 71 Hanlin ER, Zelenak J, Barakat M, Anderson KL. Airway ultrasound for the confirmation of endotracheal tube placement in cadavers by military flight medic trainees–a pilot study. Am J Emerg Med. 2018; 36:1711–4.
72 72 Carlson J, Mayrose J, Krause R, Jehle D. Extubation force: tape versus endotracheal tube holders. Ann Emerg Med. 2007; 50:686–91.
73 73 Kaufmann KF, Kupas DF, Wang HE. Do different tube securing methods affect endotracheal tube dislodgement in a prehospital setting? Prehosp Emerg Care. 2007; 11:104.
74 74 Davenport C, Martin‐Gill C, Wang HE, Mayrose J, Carlson JN. Comparison of the force required for dislodgement between secured and unsecured airways. Prehosp Emerg Care. 2018:1–4.
75 75 Wang HE, Davis DP, O'Connor RE, Domeier RM. Drug‐assisted intubation in the prehospital setting (resource document to NAEMSP position statement). Prehosp Emerg Care. 2006; 10:261–71.
76 76 Zed PJ, Mabasa VH, Slavik RS, Abu‐Laban RB. Etomidate for rapid sequence intubation in the emergency department: is adrenal suppression a concern? Can J Emer Med. 2006; 8:347–50.
77 77 Jackson WL, Jr. Should we use etomidate as an induction agent for endotracheal intubation in patients with septic shock?: a critical appraisal. Chest. 2005; 127:1031–8.
78 78 Sullivan M, Thompson WK, Hill GD. Succinylcholine‐induced cardiac arrest in children with undiagnosed myopathy. Can J Anesth. 1994; 41:497–501.
79 79 Wang HE, O'Connor RE, Megargel RE, et al. The utilization of midazolam as a pharmacologic adjunct to endotracheal intubation by paramedics. Prehosp Emerg Care. 2000; 4:14–18.
80 80 Dickinson ET, Cohen JE, Mechem CC. The effectiveness of midazolam as a single pharmacologic agent to facilitate endotracheal intubation by paramedics. Prehosp Emerg Care. 1999; 3:191–3.
81 81 Jacoby J, Heller M, Nicholas J, et al. Etomidate versus midazolam for out‐of‐hospital intubation: a prospective, randomized trial. Ann Emerg Med. 2006; 47:525–30.
82 82 Bozeman WP, Kleiner DM, Huggett V. A comparison of rapid‐sequence intubation and etomidate‐only intubation in the prehospital air medical setting. Prehosp Emerg Care. 2006; 10:8–13.
83 83 Bozeman WP, Young S. Etomidate as a sole agent for endotracheal intubation in the prehospital air medical setting. Air Med J. 2002; 21:32–5.
84 84 Weingart SD, Trueger NS, Wong N, Scofi J, Singh N, Rudolph SS. Delayed sequence intubation: a prospective observational study. Ann Emerg Med. 2015; 65:349–55.
85 85 Jarvis JL, Gonzales J, Johns D, Sager L. Implementation of a clinical bundle to reduce out‐of‐hospital peri‐intubation hypoxia. Ann Emerg Med. 2018; 72:272–9 e271.
CHAPTER 4 Airway management: special situations
Brendan Anzalone and Henry E. Wang
Introduction
The prehospital environment presents unique challenges or barriers to patient care. Airway management in some situations may be difficult or impossible. For example, airway support may need to be provided with the patient on the floor or upright while trapped in a vehicle. This chapter describes considerations and strategies for airway interventions in special prehospital situations.
Ground‐level airway management
The classic position for intubation has the patient supine at the level of the rescuer’s xiphoid. However, prehospital patients requiring airway management are often found in unusual positions, such as on the ground or floor. Conventional approaches to laryngoscopy and intubation must be modified in these scenarios.
There are several approaches to rescuer positioning for ground‐level endotracheal intubation.
Prone. The rescuer lies prone on the ground in line with the patient’s head (Figure 4.1). The rescuer places both elbows on the ground. With this approach, laryngoscopy requires lifting at the wrist rather than with the forearm. Placement of the tracheal tube must be accomplished using movements of the wrist.
Left lateral decubitus position. With this approach, the rescuer lays on his or her left side, perpendicular to the head of the patient (Figure 4.2). As with the prone position, the
