"Lasta och åk" : Akutbilens anestesisjuksköterskors uppfattningar om intubation vid traumatiska skallskador

by Gabrielsson, Göran

Studies have shown that an early intubation on patients with head injuries can have a positive effect on their condition and therefore also the outcome of the injury. However, the prehospitalized intubation is a risky procedure which can affect the outcome of the patient’s condition very negatively. If there is a great distance to the hospital certain procedures might be necessary in order to establish airflow for patients suffering from head trauma. But is this really necessary with patients only traveling short distances to the hospital? Is it better to “load and go” to quickly get to the hospital where intubation can be made under different circumstances? How does the anesthesia nurses of the emergency vehicle handle the conflict between the prehospitalized intubation and “load and go” regarding traumatic head injuries? This study was conducted by interviewing nine anesthetic nurses working in emergency vehicle around the Stockholm area. The purpose of the study was to describe and define how pre-hospitalized anesthesia personnel experiences the conflict between pre-hospitalized intubation and “load and go” regarding head traumas and the closer distances to the hospital. Furthermore, this study has used a qualitative method of phenomenongraphic procedure. The result shows that intubation can be avoided if there is a short distance to the hospital, and that there has been an assessment of the patient’s airways which concludes that the patient will survive the transportation to the hospital without further complications. However, if the distance to the hospital is longer and the patient’s airways and respiratory system requires immediate attention then the anesthetic nurses will consider intubation.