Paramedics provide life-saving emergency medical care to patients in the out-of-hospital setting, but only selected emergency interventions have proved to be safe or effective. Endotracheal intubation (the insertion of an emergency breathing tube into the trachea) is an important and high-profile procedure performed by paramedics. In our study population, we found that errors occurred in 22 percent of intubation attempts, with a frequency of up to 40 percent in selected ambulance systems. These findings indicate frequent errors associated with this life-saving technique. These events might be emblematic of larger issues in the structure and delivery of out-of-hospital emergency care.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1377/hlthaff.25.2.501 | DOI Listing |
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Objectives: Prehospital endotracheal intubation (ETI) is a lifesaving procedure with known complications. To reduce ETI-associated morbidity and mortality, organizations prioritize first-pass success (FPS). However, there are few data evaluating the association of FPS with clinician licensure.
View Article and Find Full Text PDFScand J Trauma Resusc Emerg Med
December 2024
Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Spitalgasse 23, 1090, Vienna, Austria.
Background: Emergency Medical Service crews are equipped with comprehensive emergency kits for routine care and to provide life-saving interventions in severely ill patients. While guidelines on contents and packing strategies of emergency kits for specific tasks and specialized situations exist, data for the design of out-of-hospital emergency kits in a general urban population is lacking. It may be possible to transfer the promising results of modern in-hospital packing strategies such as task-based package organization (TPO) to an Emergency Medical Service setting.
View Article and Find Full Text PDFCrit Care Explor
December 2024
Department of Clinical and Operational Research, ESO, Austin, TX.
Objectives: Accumulating basic science data, early clinical findings and various feasibility considerations have provided rationales for administering ketamine as a proposed rescue medication for midazolam-resistant status epilepticus (SE) in the logistically challenging prehospital environment. This report details the multiyear experience of paramedics managing midazolam-resistant SE following the introduction of a ketamine-rescue protocol.
Design: A 7-year, population-based, observational study was conducted to evaluate outcomes of patients treated with IV, intraosseous, intramuscular, or intranasal ketamine for SE despite sufficient midazolam dosings.
Prehosp Emerg Care
December 2024
Ornge, Mississauga, Ontario, Canada.
Healthcare (Basel)
November 2024
Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, 90-153 Lodz, Poland.
Airway management in pre-hospital settings is often challenging and difficult to perform. This is particularly true during tracheal intubation of entrapped patients with difficult airway access. There are various airway adjuncts available in the current practice.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!