Preoxygenation in prehospital critical care: a survey of HEMS practices in eight European countries

Tracheal intubation in critically ill patients carries a high risk of peri-intubation hypoxaemia.1 Effective preoxygenation is essential to extend safe apnoea time and reduce the risk of desaturation during airway management. Recent studies in emergency departments and intensive care units have shown that non-invasive ventilation (NIV) with positive end-expiratory pressure (PEEP) significantly reduces hypoxaemia compared with conventional approaches like non-rebreathable face masks (NRM).1 2 Although NIV is increasingly used in hospitals, it may be unavailable or impractical in prehospital settings, where airway interventions are still common. A retrospective analysis of over 227 000 Emergency Medical System (EMS) missions in Germany found that 8% of patients required advanced airway management.3