Pediatric Out-of-Hospital Intubations: Experience of a Single EMS Agency

In a retrospective study of pediatric (<13 years) prehospital paramedic airway management in King County, Washington, investigators assessed the incidence and outcomes of intubation attempts during a 6-year period. Overall, 299 calls (0.05% of all calls) involved attempted pediatric intubation, 51% with rapid sequence intubation. Individual paramedics averaged no more than one pediatric intubation every 2.6 years. Twenty-five percent of patients died at the scene, and 27% of transported patients died in the hospital. Indications for intubation included cardiac arrest (44%) and neurologic diagnoses (19%; most commonly status epilepticus).

First-attempt success rate was 66%. Bodily fluids interfering with laryngeal view was the most common rea…