Emergency Care

Study characterizes patients receiving out-of-hospital endotracheal intubation

Endotracheal intubation (ETI), a medical procedure in which a tube is placed through the mouth and into the windpipe (trachea), is a key procedure performed by paramedics in the United States. A new study sheds light on what medical conditions are associated with out-of-hospital paramedic ETI. Medical directors could use this information to prioritize airway management options and strategies for emergency medical services agencies.

A team of researchers led by Henry E. Wang, M.D., of the University of Alabama at Birmingham linked 25,733 successful ETIs performed by paramedics in Pennsylvania during 2003-2005 to death or hospital records. More than half of the group (56.3 percent) died before hospital admission and 43.7 percent survived to hospital admission.

The majority of successful ETIs occurred on patients with cardiac arrest and circulatory and respiratory conditions. Among the 11,255 hospitalized patients who received out-of-hospital ETI, the leading primary diagnosis groups were circulatory diseases (32 percent), respiratory diseases (23 percent), and injury or poisoning (25 percent). Among the patients who had died prior to hospital admission, most (93 percent) suffered from nontraumatic cardiac arrest. This study was supported in part by the Agency for Healthcare Research and Quality (HS13628).

See "Medical conditions associated with out-of-hospital endotracheal intubation" by Dr. Wang, G.K. Balasubramani, Ph.D., Lawrence J. Cook, Ph.D., and others in the July/September 2011 Prehospital Emergency Care 15, pp. 338-346.

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