title: Characteristics and outcome of prehospital paediatric tracheal intubation attended by anaesthesia-trained emergency physicians.
abstract: OBJECTIVE
  To collect data regarding prehospital paediatric tracheal intubation by emergency physicians skilled in advanced airway management.
  
  
  METHODS
  A prospective 8-year observational study of a single emergency physician-staffed emergency medical service. Self-reporting by emergency physicians of all children aged 0-14 years who had prehospital tracheal intubation and were attended by either anaesthesia-trained emergency physicians (group 1) or by a mixture of anaesthesia and non-anaesthesia-trained emergency physicians (group 2).
  
  
  RESULTS
  Eighty-two out of 2040 children (4.0%) had prehospital tracheal intubation (58 in group 1). The most common diagnoses were trauma (50%; in school children, 73.0%), convulsions (13.4%) and SIDS (12.2%; in infants, 58.8%). The overall tracheal intubation success rate was 57 out of 58 attempts (98.3%). Compared to older children, infants had a higher number of Cormack-Lehane scores of 3 or 4, "difficult to intubate" status (both 3 out of 13; 23.1%) and a lower first attempt success rate for tracheal intubation (p=0.04). Among all 82 children 71 (86.6%) survived to hospital admission and 63 (76.8%) to discharge. Of the 63 survivors, 54 (85.7%) demonstrated a favourable or unchanged neurological outcome (PCPC 1-3). The survival and neurological outcomes of infants were inferior compared to older children (p<0.001). On average an emergency physician performed one prehospital tracheal intubation in 3 years in a child and one in 13 years in an infant.
  
  
  CONCLUSIONS
  Anaesthesia-trained emergency physicians working in our system report high success rates for prehospital tracheal intubation in children. Survival and neurological outcomes were considerably better than reported in previous studies.
authors.affiliation: Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre, 37075 Göttingen, Germany. ceich@med.uni-goettingen.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Eich
authors.forename: Markus
authors.initials: M
authors.lastname: Roessler
authors.forename: Marcus
authors.initials: M
authors.lastname: Nemeth
authors.forename: Sebastian G
authors.initials: SG
authors.lastname: Russo
authors.forename: Jan F
authors.initials: JF
authors.lastname: Heuer
authors.forename: Arnd
authors.initials: A
authors.lastname: Timmermann
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000776:Anesthesiology / Q000193:education*; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D004635:Emergency Medicine / Q000193:education*; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome