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Success in physician prehospital rapid sequence intubation: what is the effect of base speciality and length of anaesthetic training?
  1. Tim Harris1,
  2. David Lockey2,3
  1. 1London HEMS and Department of Emergency Medicine, Royal London Hospital, London, UK
  2. 2London Air ambulance, London, UK
  3. 3Frenchay Hospital, Bristol, UK
  1. Correspondence to Dr Tim Harris, London HEMS and Department of Emergency Medicine, Royal London Hospital, Whitechapel, London E11BB, UK; tim.harris{at}bartsandthelondon.nhs.uk

Abstract

There is conflicting evidence concerning the role and safety of prehospital intubation, and which providers should deliver it. Success rates for physician-performed rapid sequence induction are reported to be 97–100%, with limited evidence of improved survival in some patient groups. However, there is also evidence that prehospital intubation and ventilation can do harm. Prospective data were recorded on the success of intubation, the quality of the laryngeal view obtained and the number of attempts at intubation. These data were then analysed by the grade of intubating doctor and whether the intubating doctor had a background in anaesthesia or emergency medicine. All groups had a similar success rate after two attempts at intubation. Doctors with a background in anaesthesia and consultant emergency physicians had a significantly better first-pass intubation rate than emergency medicine trainees. The quality of laryngeal view was significantly better in doctors with an anaesthetics background.

  • Airway
  • anaesthesia
  • ECG
  • intubation
  • medical training
  • nursing
  • prehospital care
  • RSI
  • training

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Footnotes

  • A summary of this paper was presented at the stand-up science session of the London Trauma Conference, London, December 2009. An abstract was submitted to the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, which published all abstracts from this conference.

  • Funding The funding for the statistical analysis was provided by the London air ambulance charitable foundation. The statistical analysis was funded by London HEMS.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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