ABSTRACTS
Influence of Patient Weight on Prehospital Advanced Airway Procedure Success RateAuthor: Michael W. Hubble, PhD, MBA, NRP | | Associate Authors: Melisa D. Martin, EdD, MHS, Sara E. Houston, MHS, NRP, Stephen Taylor, MHS, Jennifer O'Neal, Paramedic, Beth Himes, BS, Paramedic, Ginny K. Renkiewicz, PhD
Introduction Previous investigations of the relationship between obesity and difficult airway management have provided mixed results. Almost universally, these studies were conducted in the hospital setting, and the influence of body weight on successful prehospital airway management remains unclear. Objective To explore the relationship between patient weight and problematic airway interventions. Methods We conducted a retrospective analysis using the 2020 ESO Data Collaborative dataset. Adult patients weighing ≥ 31 kg with an attempted orotracheal intubation (OTI) and/or blind insertion airway device (BIAD) were included. Separate logistic regression models were used to determine the influence of weight (dichotomized at 100 kg) on cumulative procedure success for OTI and BIAD, and linear regression was used to identify trends for each across weight strata. Results A total of 23,537 patients received an OTI attempt and 27,191 received a BIAD attempt. After controlling for patient age, sex, minority status, and call type (medical vs. trauma), weight > 100 kg was associated with decreased OTI success (OR = 0.64, p < 0.001), but higher likelihood of BIAD success (OR = 1.31, p < 0.001). OTI success was associated with a negative 0.6% linear trend per 5 kg of body weight (p < 0.001), while BIAD success had a 0.2% positive trend (p < 0.001). Conclusion This retrospective analysis from a national database revealed that increasing patient weight is negatively associated with intubation success. A positive, but smaller, linear trend was observed for BIAD placement. Elevated patient weight may be an easily identifiable predictor of difficult OTI and should be considered when selecting an airway management strategy.
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