Effect of an airway education program on prehospital intubation.
BACKGROUND
The purpose of this study was to determine the impact of an airway education program (AEP) on prehospital intubation.


METHODS
University-based air medical program


METHODS
Retrospective review of 372 consecutive intubations for 3 years before and 3 years after the institution of an AEP. Descriptive statistics were used and comparisons were made using chi-square analysis.


RESULTS
Intubation success rate was 170/180 (94%) for the preAEP group and 186/192 (97%) for the postAEP group (P > 0.05). Neuromuscular blockade (NMB) was used in 113/180 (63%) of preAEP intubations and 145/192 (76%) of postAEP intubations (P < 0.01). NMB without sedation decreased from 62/113 (55%) in the preAEP group to 12/145 (8%) in the postAEP group (P < 0.001). Cricothyrotomy rate decreased from 10/180 (6%) in the preAEP group to 3/192 (2%) in the postAEP group (P < 0.05). Failed intubation rate in nonarrested patients during the 6-year period was 10/154 (6%) in patients receiving no medications or partial rapid sequence intubation (RSI) compared with 3/184 (2%) in patients who had full RSI (P < 0.025).


CONCLUSIONS
Establishment of an AEP resulted in an increase in NMB for intubation, a dramatic decrease in the use of NMB without sedation, and a decrease in cricothyrotomy rate. The rate of intubation failure in nonarrested patients was higher in those who received no medications or partial RSI compared with full RSI.
Swanson
Eric R
ER
Division of Emergency Medicine and AirMed, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA. eswanson.airmed@attbi.com
Fosnocht
David E
DE
D017732:Air Ambulances / Q000592:standards*; D004509:Education, Nursing, Continuing / Q000592:standards; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education* / Q000592:standards; D016529:Emergency Nursing / Q000193:education* / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D007442:Intubation, Intratracheal / Q000451:nursing / Q000592:standards*; D008348:Manikins; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D014589:Utah