Survey of out-of-hospital emergency intubations in the French prehospital medical system: a multicenter study.
OBJECTIVE
To determine the clinical characteristics of endotracheal intubation in the French emergency prehospital medical system and compare these data with those of other systems.


METHODS
This study was performed in lle de France (Paris Region) in mobile ICUs staffed by physicians. This prospective, descriptive study involved completion of a questionnaire by the operator just after endotracheal intubation was performed.


RESULTS
Six hundred eighty-five (99.1%) of 691 consecutive prehospital intubations were performed successfully in the field. The orotracheal route was used in 96.0%, and no surgical approaches such as cricothyroidotomy were used. Mechanical complications occurred in 84 patients, at a rate of 15.9% for nonarrest patients and 8.1% for arrest patients. A wide variety of sedation protocols were used. Difficult intubations (10.8%) were comparable in incidence to the number seen in US emergency departments, not US prehospital systems. By the same token, intubation success rates (99.1%) were comparable to US EDs and much higher than US prehospital results.


CONCLUSIONS
The characteristics of French prehospital airway management differ significantly from those of other countries. These differences may be explained by differences in approach to prehospital management rather than differences of skill.
CHU Avicenne, University Paris XIII, Bobigny, France. fadnet@compuserve.com
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F
Adnet
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NJ
Jouriles
P
P
Le Toumelin
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B
Hennequin
C
C
Taillandier
F
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Rayeh
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Couvreur
B
B
Nougière
P
P
Nadiras
A
A
Ladka
M
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Fleury
D002985:Clinical Protocols; D004632:Emergency Medical Services; D004638:Emergency Treatment / Q000009:adverse effects; D005602:France; D006801:Humans; D006993:Hypnotics and Sedatives; D007442:Intubation, Intratracheal / Q000009:adverse effects; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D006993:Hypnotics and Sedatives