title: Prehospital endotracheal intubation vs extraglottic airway device in blunt trauma.
abstract: OBJECTIVE
  The objective of the study is to compare outcomes in blunt trauma patients managed with prehospital insertion of an extraglottic airway device (EGD) vs endotracheal intubation (ETI). The null hypothesis was that there would be no difference in mortality for the 2 groups.
  
  
  METHODS
  This is a retrospective study of blunt trauma patients with Glasgow Coma Scale score less than or equal to 8 transported by ground emergency medical services directly from the scene of injury to a single urban level 1 trauma center. Patients managed with only noninvasive airway techniques were excluded, leaving patients undergoing either EGD placement or ETI. Outcomes included in-emergency department (ED) traumatic arrest and hospital mortality. Multivariable logistic regression was used to control for the potential confounding effects of demographic and clinical variables. For all analyses, P < .05 was used to establish statistical significance.
  
  
  RESULTS
  In bivariate analysis, patients managed with EGD were more likely than those managed with ETI to have an in-ED traumatic arrest (36.5% vs 17.1%; P = .005), but eventual hospital mortality did not significantly differ between the 2 groups (75.7% vs 67.1%; P = .228). After controlling for demographic and clinical characteristics, patients managed with EGD were no more likely than patients managed with ETI to experience traumatic arrest in the ED (adjusted odds ratio, 1.67; 95% confidence interval, 0.72-3.89), and there was also no difference in overall hospital mortality (adjusted odds ratio, 0.912; 95% confidence interval, 0.36-2.30).
  
  
  CONCLUSIONS
  In this preliminary, retrospective analysis, we found no difference in overall survival among trauma patients managed with prehospital EGD and those managed with prehospital ETI.
authors.affiliation: Emergency Medicine Residency Program, University of Texas-Austin and University Medical Center Brackenridge, Austin, TX 78701.
authors.forename: James
authors.initials: J
authors.lastname: Kempema
authors.affiliation: Department of Surgery, University of Texas-Austin and University Medical Center Brackenridge, Austin, TX 78701.
authors.forename: Marc D
authors.initials: MD
authors.lastname: Trust
authors.affiliation: Department of Surgery, University of Texas-Austin and University Medical Center Brackenridge, Austin, TX 78701.
authors.forename: Sadia
authors.initials: S
authors.lastname: Ali
authors.affiliation: Austin-Travis County Office of the Medical Director, Austin, TX 78741.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Cabanas
authors.affiliation: Austin-Travis County Office of the Medical Director, Austin, TX 78741.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Hinchey
authors.affiliation: Emergency Medicine Residency Program, University of Texas-Austin and University Medical Center Brackenridge, Austin, TX 78701; Mount Isa Centre for Rural & Remote Health, James Cook University, Townsville, QLD, Australia, 4811. Electronic address: Lawrence.Brown@my.jcu.edu.au.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Brown
authors.affiliation: Department of Surgery, University of Texas-Austin and University Medical Center Brackenridge, Austin, TX 78701.
authors.forename: Carlos V R
authors.initials: CV
authors.lastname: Brown
mesh_terms: D015998:Abbreviated Injury Scale; D000328:Adult; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult