Air Medical Curricula in Emergency Medicine Residencies: A National Survey.

OBJECTIVE: The aim of this study was to determine if a common air medical curriculum exists among Accreditation Council for Graduate Medical Education (ACGME) emergency medicine (EM) residencies. METHODS: Institutional review board exemption was obtained. A cross-sectional survey study design was used. All ACGME-approved EM residencies as of February 2013 were identified, and the program directors were e-mailed a 3-question survey. Descriptive statistics were calculated for each response, and a response bias analysis was completed. RESULTS: All 160 ACGME EM residencies were contacted by e-mail. One hundred six (66%) programs responded. Sixty-nine (65%) of the respondents offered an air medical experience. Only 25 of the 69 (36%) stated that they had a formal air medical curriculum, and 15 programs provided a copy of their curriculum. Protocol education was present in 80% of programs. Safety training was present in 60% of the programs. Financial education was present in 7% of programs. There was no statistically significant difference between responders and nonresponders except for residency class size. CONCLUSION: After 30 years of published articles and position statements calling for standardized air medical resident crew member training, there is still no standardized training program among emergency medicine residencies.

Successful airtraq use in an air medical transport system.

INTRODUCTION: There is a large body of literature that shows that the AirTraq device achieves equal or superior rates of successful intubation in all classes of user. A recent prospective human trial of the device questioned the first pass success rate and whether effective training could occur outside the Operating Room (OR). The purpose of this study was to investigate the first pass success rate for intubation with the AirTraq (AT) device utilizing only mannequin training in an air ambulance setting from Aug. 1 2009 to Aug. 1 2012 and compare it to direct laryngoscopy (DL). HYPOTHESIS: We hypothesize that the AirTraq device will be as effective overall as direct laryngoscopy, and that this requires no OR training to achieve. METHODS: A retrospective chart review of 161 intubations by air ambulance flight nurses from Aug. 1, 2009 to Aug. 1, 2012 was conducted. Data regarding date of service, devices used, number of attempts, rescue device use, and complications was gathered and analyzed. The generalized estimating equation and the chi-squared test were used to evaluate the data. RESULTS: 161 intubations were reviewed. 135 met inclusion criteria. Overall first pass success rate for AT was 82% (68/83) and DL was 74% (35/47). Overall first use success rate for AT was 79% (71/90) and DL was 70% (43/61). The overall success rate of intubation for any patient in which either AT or DL was attempted is 96% (130/135). CONCLUSION: AirTraq was shown to be as effective as direct laryngoscopy. All air crew training for the AirTraq device was performed on mannequins. The successof the device compared to DL shows that mannequin training is sufficient to implement the AirTraq device for pre-hospital intubation.