BACKGROUND Up to one in eight trauma patients arrive at a hospital with a partially or completely obstructed airway. The UK National Institute for health and Care Excellence (NICE) practice guidelines recommend that trauma patients requiring anaesthesia for definitive airway management receive this care within 45 min of an emergency call, preferably at the incident scene. How frequently this target is achieved remains unclear. We assessed the recorded time to pre-hospital emergency anaesthesia after trauma across UK helicopter emergency medical service (HEMS) units. METHODS We retrospectively recorded time to pre-hospital emergency anaesthesia across all 20 eligible UK HEMS units (comprising 52 enhanced care teams) from April 1, 2017 to March 31, 2018. Times recorded for emergency notification, dispatch, arrival, and neuromuscular blocking agent administration were analysed. RESULTS HEMS undertook 1755 pre-hospital emergency anaesthetics for trauma across the UK during the study period. There were 1176/1755 (67%) episodes undertaken by helicopter response teams during daylight hours. The median time to pre-hospital emergency anaesthesia was 55 min (inter-quartile range: 45-70); anaesthesia within 45 min of the initial emergency call was achieved in 25% cases. Delayed dispatch time (>9 min) was associated with fewer patients receiving pre-hospital anaesthesia within 45 min (odds ratio: 7.7 [95% confidence intervals: 5.8-10.1]; P<0.0001). CONCLUSIONS The time to achieve pre-hospital emergency anaesthesia by UK HEMS frequently exceeds the recommended 45 min target. Reducing the time to dispatch of emergency medical teams may impact on the delivery of pre-hospital emergency anaesthesia.

中文翻译：

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英国院前紧急麻醉：一项观察性队列研究。

背景技术多达八分之一的创伤患者到达呼吸道部分或完全阻塞的医院。英国国家健康与护理卓越研究所（NICE）的实践指南建议，需要麻醉以进行最终气道管理的创伤患者应在紧急呼叫后45分钟内（最好在事故现场）接受这种护理。目前尚不清楚该目标多久实现一次。我们评估了英国直升飞机急诊医疗服务（HEMS）单位发生创伤后记录的院前紧急麻醉时间。方法我们回顾性记录了2017年4月1日至2018年3月31日在所有20个符合条件的UK HEMS单位（包括52个增强护理团队）中进行院前急诊麻醉的时间。分析神经肌肉阻滞剂的使用。结果在研究期间，HEMS在英国进行了1755例院前急诊麻醉剂用于创伤治疗。在白天，直升飞机响应小组进行了1176/1755次（67％）发作。院前紧急麻醉的中位时间为55分钟（四分位间距：45-70）；25％的病例在首次紧急呼叫后45分钟内完成了麻醉。延迟派遣时间（> 9分钟）与在45分钟内接受院前麻醉的患者较少相关（优势比：7.7 [95％置信区间：5.8-10.1]； P <0.0001）。结论UK HEMS进行院前紧急麻醉的时间经常超过建议的45分钟目标。