More Disturbing News About Prehospital Trauma Intubation

Prehospital intubation (PHI) has come under fire as studies have reported high rates of failure and complications (JW Emerg Med Mar 30 2007 and Apr 1 2000). To determine the effectiveness of PHI in a single urban trauma system, researchers in Miami reviewed the records of all 203 patients who received PHI during a 34-month period.

PHI, defined as endotracheal intubation, use of a laryngeal mask airway (LMA) or Combitube, or cricothyrotomy before ED arrival, was successful in 69% of patients. Intubation failure, defined as improper location of the endotracheal tube or the need for a rescue device after failed intubation attempts, occurred in 31% of all patients and included unrecognized esophageal intubation (12%), Combitube use (14%), LMA us…