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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Paramedic intubation errors: isolated events or symptoms of larger problems?
Henry E Wang1, Judith R Lave, Carl A Sirio
1Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pennsylvania, USA. wanghe@upmc.edu
Paramedic endotracheal intubation errors occurred in 22% of attempts, reaching 40% in some systems. These findings highlight frequent errors in this critical life-saving procedure and may reflect broader issues in emergency care delivery.
Area of Science:
- Emergency medicine
- Pre-hospital care
- Medical procedures
Background:
- Paramedics deliver critical out-of-hospital emergency medical care.
- Not all emergency interventions performed by paramedics are proven safe or effective.
- Endotracheal intubation is a key, high-profile paramedic procedure.
Purpose of the Study:
- To assess the frequency of errors during paramedic-performed endotracheal intubation.
- To identify potential systemic issues in out-of-hospital emergency care delivery.
Main Methods:
- Retrospective analysis of endotracheal intubation attempts by paramedics.
- Data collection on error rates within the study population.
- Analysis of error frequency across different ambulance systems.
Main Results:
- Errors were observed in 22% of all intubation attempts studied.
- Error rates reached up to 40% in specific ambulance systems.
- Findings indicate a high frequency of errors in this life-saving procedure.
Conclusions:
- Frequent errors in paramedic endotracheal intubation are a significant concern.
- These errors may indicate underlying problems in the structure and delivery of emergency medical services.
- Further investigation into out-of-hospital care systems is warranted.
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