Out-of-hospital endotracheal intubation: where are we?
While remaining prominent in paramedic care and beneficial to some patients, out-of-hospital endotracheal intubation has not clearly improved survival or reduced morbidity from critical illness or injury when studied more broadly. Recent studies identify equivocal or unfavorable clinical effects, adverse events and errors, interaction with other important resuscitation interventions, and challenges in providing and maintaining procedural skill. We provide an overview of current data evaluating the overall effectiveness, safety, and feasibility of paramedic out-of-hospital endotracheal intubation. These studies highlight our limited understanding of out-of-hospital endotracheal intubation and the need for new strategies to improve airway support in the out-of-hospital setting.
Wang
Henry E
HE
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. wanghe@upmc.edu
Yealy
Donald M
DM
D000488:Allied Health Personnel / Q000193:education; D002983:Clinical Competence; D004517:Education, Professional / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods*; D014943:Global Health; D006801:Humans; D007442:Intubation, Intratracheal; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000379:methods; D012449:Safety; D016896:Treatment Outcome