Clinical characteristics of paramedics' performance of endotracheal intubation

Abstract

Paramedics intubated 358 of 383 (93.5%) patients over a nine-month period. There were 85 survivors. The intubators used the curved-blade laryngoscope in 304 patients (79.5%). Two of 25 (8.0%) patients who were not successfully intubated lived; 83 of 358 (23.2%) successfully intubated patients survived. Clinically significant complications occurred in 32 patients (8.9%) who were successfully intubated. Paramedics encountered adverse conditions in 126 patients (32.9%). Presenting cardiac rhythm was recorded. There were no significant differences in intubation success rate between survivors and nonsurvivors or as a function of cardiac rhythm. This retrospective study further documents the ability of paramedics to successfully perform endotracheal intubation. The high success rate supports training with live subjects. Further studies of cause and impact of complications, correlation of success with increased survival, and alternative techniques are essential for effective EMS system medical control.