Esophageal and Endobronchial Intubation in Prehospital Care

Seventeen percent of tubes were placed in the esophagus or mainstem bronchus by undertrained, underequipped physicians in this German study.

Previous studies have documented misplacement of endotracheal tubes during out-of-hospital intubation, with unrecognized esophageal placement rates of up to 25% (Journal Watch Emergency Medicine Jul 28 2004; Sep 24 2003;Mar 21 2001). Investigators in Germany determined the incidence of endotracheal intubations by surgeons, anesthesiologists, and internists from local hospitals who participated in emergency services at least 1 day per month in addition to their usual clinical responsibilities.

After the responding physician completed prehospital intubation and confirmed tube placement by physical examination only (auscultation, chest movement), an anesthesiologist (study physician) with 300 or more emergency calls or 3 years of ground-based a…

Reviewing Author

Ron M. Walls, MD, FRCPC, FAAEM, FACEP