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Joint Royal College Ambulance Liaison Committee Airway Working Group commentary
  1. Mike Jackson
  1. Correspondence to Mr Mike Jackson, North West Ambulance Service NHS Trust, Ambulance Headquarters, Ladybridge Hall, Chorley New Road, Heaton, Bolton BL1 5DD, UK; mike.jackson{at}nwas.nhs.uk

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The publication of the paper by the Joint Royal College Ambulance Liaison Committee Airway Working Group (JRCALC AWG) will no doubt start a fierce debate among the paramedic and medical professions about prehospital intubation.

Prehospital intubation performed by paramedics is a profession-defining skill, has been practised by paramedics in the UK for over 20 years, and has been a mainstay of prehospital airway management. In a survey of paramedics in the USA, prehospital intubation was ranked as a more important skill than defibrillation and patient assessment.1

Most of the literature reviewed by the JRCALC AWG was from the USA and included studies of drug-assisted intubation. Wang and associates2 examined 592 attempts at intubation in one year and found 536 of these to be successful (90.5%); another study of 264 paediatric prehospital intubations reported a much higher success rate of 99%,3 Bulger and colleagues4 in Seattle reported a success rate of 98.4% and in Bellingham, Washington, Wayne and Friedland5 reported a 95.5% success rate.

It must be said that there are significant differences in the training …

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