title: [Out-of-hospital tracheal intubation practice by advanced level ambulance crews and reeducation program for skill retention: survey of emergency life saving technicians].
abstract: BACKGROUND
  Five years have passed since out-of-hospital tracheal intubation training for advanced level ambulance crews (emergency life saving technicians: ELSTs) was started in Japan. Herein, we reviewed results of the initial training and reeducation program.
  
  
  METHODS
  Using a questionnaire sent by post, we surveyed out-of-hospital tracheal intubations performed by 19 ELSTs trained at Hiroshima University Hospital.
  
  
  CONCLUSIONS
  Sixty-three tracheal intubations were attempted between 2004 and 2009, of which 56 (89%) were successful and 7 (11%) unsuccessful, with ventilation maintained using another means such as a laryngeal mask airway or bag-valve-mask in the latter cases. Esophageal intubation occurred in 6 cases, but were immediately recognized and dealt with appropriately. Only 1 failed intubation patient, in whom esophageal intubation was changed to bag-valve-mask ventilation, survived until discharge. The average number of yearly intubation attempts (1.2) was small, thus nearly all ELSTs replied that they desired a reeducation program to maintain their intubation skills. Furthermore, some expressed a preference to receive reeducation under conditions close to actual emergency settings. That latter finding reflects the difficulty of out-of-hospital tracheal intubation performed in adverse conditions, such as in inappropriate patient or rescuer positions, and secretion or bleeding in the oral cavity.
authors.affiliation: Departments of Anesthesiology and Critical Care, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Kusunoki
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamoto
mesh_terms: D000328:Adult; D000552:Ambulances; D002983:Clinical Competence; D003479:Curriculum; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D011795:Surveys and Questionnaires