[Seriously injured patients intubated at the accident site. A three-year survey from the mobile emergency care unit in Aarhus].
BACKGROUND
The success rate of out-of-hospital endotracheal intubations performed by paramedics has been questioned. It seems to be difficult to achieve and keep a routine. The aim was to describe the severity of injuries and the number of such intubations in trauma patients treated by the Mobile Emergency Care Unit (MECU) staffed with an anaesthetist.


METHODS
The case records of all trauma patients on whom the MECU, Arhus, performed endotracheal intubation at the accident site from 1 May 1997 to 30 April 2000 were studied. Lesions were classified according to the abbreviated injury scale (AIS), and the injury severity scores (ISS) were calculated. Severe injury was defined as an ISS > 15.


RESULTS
Over the three-year period the MECU attended 2546 trauma patients, 95 (3.7%) of whom were intubated at the site. In one case, endotracheal intubation was not possible and cricothyrotomy had to be performed. Of the patients intubated at the site 65 had an ISS > 15. This, according to previous studies, corresponded to about 20% of all severely injured patients arriving at our hospital. Sixty patients had severe lesions in the head region. In sixty-eight cases (72%) endotracheal intubation was preceded by anaesthesia.


CONCLUSIONS
Out-of-hospital endotracheal intubation of trauma patients was not a frequent intervention, as compared to all emergency calls, but it was relatively frequent in the severely injured brought to our hospital. If endotracheal intubation is to be one of the available interventions in the prehospital setting, this study confirms that it should preferably be done by physicians experienced in intubation and anaesthesia.
Hansen
Troels Martin
TM
Arhus Universitetshospital, Arhus Kommunehospital, anaestesiologisk og intensiv afdeling. tmhansen@dadlnet.dk
Høyer
Claus Christian Schovsbo
CC
Laustrup
Torben Krabbe
TK
Landsfeldt
Uffe Steen
US
Christensen
Erika Frischknecht
EF
D015998:Abbreviated Injury Scale; D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D003718:Denmark / Q000453:epidemiology; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015601:Injury Severity Score; D007442:Intubation, Intratracheal / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D000078329:Workforce; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality / Q000628:therapy*