[Out-of-hospital tracheal intubation practice by advanced level ambulance crews and reeducation program for skill retention: survey of emergency life saving technicians].
Masui. The Japanese journal of anesthesiology · 2011-06-01 · Observational study
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. RESULTS AND 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.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Bag-valve-mask ventilation · Endotracheal intubation · Paramedics & EMTs · Supraglottic airway
Related articles
- Pre-hospital airway management by non-physicians in Northern Finland -- a cross-sectional survey. (Acta Anaesthesiol Scand, 2013)
- Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts. (Prehosp Emerg Care, 2017)
- Prehospital advanced airway management by ambulance technicians and paramedics: is clinical practice sufficient to maintain skills? (Emerg Med J, 2009)
- Outcomes With the Use of Bag-Valve-Mask Ventilation During Out-of-hospital Cardiac Arrest in the Pragmatic Airway Resuscitation Trial. (Acad Emerg Med, 2020)
- Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review. (CJEM, 2010)
- Tracheal Malplacement of the King LT Airway May Be an Important Cause of Prehospital Device Failure. (J Emerg Med, 2016)