Regional EMS experience with etomidate for facilitated intubation.
OBJECTIVE
To report the preliminary experience of the Central New York emergency medical services (EMS) region with etomidate for prehospital facilitated intubation.


METHODS
Prospective recording of all intubations (facilitated and nonfacilitated) was completed during the first six months of the etomidate protocol, from January 1 to June 30, 2000. These results were compared with retrospective comparison data obtained for an 18-month period from stored documented prehospital care reports (PCRs), a period when diazepam was used for facilitated intubation.


RESULTS
During the study period, 343 (84%) of 409 attempted intubations were successful. Of these, 24 facilitated intubations (using etomidate) were attempted (all on breathing, agitated patients), and 19 (79%, CI 63%-95%) were successful. Eighteen of these (95%) were intubated successfully on the first attempt. The median age of the patients requiring intubation was 70 years (range 14-90), and 60% were female. There were no reported incidences of vomiting, broken teeth, or bleeding. The region's prior 18-month experience using diazepam for facilitated intubation resulted in ten (23%, CI 1%-36%) successful intubations of 43 facilitated intubation attempts.


CONCLUSIONS
Preliminary data suggest increased rates of success for facilitated intubation using etomidate, when compared with diazepam, with most intubations successful on the first attempt. Limitations of this study include a small sample size and self-reporting of airway data by paramedics.
Reed
David B
DB
Department of Emergency Medicine, State University of New York, Upstate Medical University, Syracuse 13210, USA. reedd@upstate.edu
Snyder
Gwendolyn
G
Hogue
Troy D
TD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D003975:Diazepam / Q000627:therapeutic use; D004632:Emergency Medical Services / Q000379:methods; D004634:Emergency Medical Technicians; D005045:Etomidate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009518:New York; D011446:Prospective Studies; D012107:Research Design; D012189:Retrospective Studies; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D003975:Diazepam; D005045:Etomidate