How many attempts are required to accomplish out-of-hospital endotracheal intubation?

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Henry E Wang, Donald M Yealy

Abstract

An important goal of emergency airway management is to complete endotracheal intubation (ETI) correctly, safely, and quickly, and repeated ETI attempts can increase patient morbidity and mortality. Clinical protocols limiting the number of ETI attempts may minimize harm, but this strategy also may reduce the frequency of successful ETI. To characterize the relationship between the number of out-of-hospital ETI attempts and ETI success. This study used prospective, multicenter data from 42 emergency medical services agencies from an 18-month period. Out-of-hospital rescuers (paramedics, out-of-hospital nurses, and physicians) completed structured, closed-response data forms describing clinical methods, course, and outcomes for all ETIs. An ETI attempt was defined as an insertion of the laryngoscope blade. Rescuers identified ETI outcome (success or failure) for each attempt. The authors defined overall success as ETI outcome (success or failure) on the last attempt, examining cardiac arrest, conventional nonarrest, sedation-facilitated, and rapid-sequence ETI separately. Univariate odds ratios (ORs) were used to identify the number of ETI attempts in which the cumulative ETI success rate approached the overall ETI success rate. ...Continue Reading

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Dec 24, 2003·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Henry E WangUNKNOWN National Association of EMS Physicians

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Citations

Jan 20, 2011·Critical Care : the Official Journal of the Critical Care Forum·Hans Morten LossiusDavid J Lockey
Apr 12, 2014·BioMed Research International·Tomas HenlinMilos Dobias
Jan 23, 2015·Der Anaesthesist·T A JuratliS B Sobottka
Sep 7, 2011·Heart & Lung : the Journal of Critical Care·Theodoros XanthosNicoletta Iacovidou
Jul 8, 2008·Air Medical Journal·R J FrasconeJosh Salzman
Oct 28, 2008·Resuscitation·Henry E WangJudith R Lave
May 10, 2008·Current Opinion in Critical Care·Jerry P Nolan, Jasmeet Soar
Nov 4, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Scott T YoungquistRoger J Lewis
Apr 10, 2010·Journal of Korean Neurosurgical Society·Salih GulsenNur Altinors
Sep 15, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jonathan R StudnekTom Blackwell
Sep 15, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Henry E Wang, Sandy Bogucki
Oct 2, 2020·Journal of the American College of Emergency Physicians Open·Henry E Wang, Jonathan R Benger
Sep 8, 2020·Critical Care Clinics·Jestin N Carlson, Henry E Wang
Jan 19, 2021·Air Medical Journal·María Florencia García-PintosErik G Laurin

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