Adult ; Aged ; Aged, 80 and over ; Emergencies ; Emergency Service, Hospital* ; Female ; Humans ; Intubation, Intratracheal*/adverse effects ; Intubation, Intratracheal*/standards ; Male ; Middle Aged ; Pilot Projects ; Program Evaluation ; Telemedicine/methods* ; Time Factors ; Treatment Outcome
Abstract
We developed a telemedicine system for remote guidance of emergency airway management called the Tele-Airway Management System (TAMS). In a pilot study we examined the usefulness of the TAMS for intubations of actual patients in a hospital emergency department. Twenty-five patients were allocated randomly either to a TAMS group or to an on-scene directed (OSD) group. A total of 12 were intubated using the TAMS. The mean time to intubation (TAMS 62 s vs. OSD 56 s) and the success rate was not different between the two groups (P > 0.05). There were two oesophageal intubations in the TAMS group and four in the OSD group, but this was not significantly different (P = 0.36). There were no mechanical or technical errors such as disconnection during use of the TAMS. The pilot study demonstrated the feasibility of the TAMS as an alternative to OSD. However, a larger study will be required to determine non-superiority or equivalence.