"Having solid evidence for what method is most effective allows us to offer the best care possible to patients in these life-or-death situations," said William Bozeman, M.D., lead author, from Wake Forest University Baptist Medical Center.
Results from the study are reported in the current issue of Prehospital Emergency Care. It compared the combination of sedative and paralytic drugs (to relax the airway and the patient), with the use of a sedative alone.
Previous studies had compared drug protocols, but looked only at whether insertion of the breathing tube was successful. The current study went a step further and measured and recorded the condition of the airway. Even if the insertion, or intubation, is successful, there can be damage to the airway or other complications that can result in disability or death.
For each patient, the crew recorded the airway conditions, such as whether the vocal cords were visible, whether the patient was relaxed and whether the intubation was successful. The study involved 49 patients who were transported over a year's time by two helicopters in the same system.
Each helicoptor's medical crew consisted of a nurse and paramedic with a mean of 18 years of medical experience and seven years of flight experience. For six months, one helicoptor's patients received the sedative alone and the other helicoptor's patients got the combination of a sedative and a paralytic drug. For the next six months, the protocols were switched. Before the study was conducted, the air ambulance service had used both protocols.