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Clinical characteristics of paramedics' performance of pediatric endotracheal intubation
1Alameda County Emergency Service Medical District, Oakland, CA.
Insights
Paramedics achieved an 88.9% success rate for pediatric endotracheal intubation, comparable to adult success rates. This study supports including this vital procedure in paramedic training and practice for improved pediatric emergency care.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Prehospital Care
Background:
- Limited data exist on prehospital pediatric intubation success rates, complications, and efficacy.
- Pediatric airway management presents unique challenges for emergency medical services (EMS) providers.
Purpose of the Study:
- To evaluate the success rates, complications, and efficacy of endotracheal intubation performed by paramedics in pediatric patients.
- To determine if paramedics can achieve success rates comparable to adult intubation outcomes.
Main Methods:
- Prospective 12-month study of prehospital endotracheal intubations in patients aged newborn to 14 years.
- Data collected on intubation attempts, success rates, patient survival to hospital admission, and equipment used (e.g., straight blade).
Main Results:
- Paramedics successfully intubated 32 of 36 (88.9%) pediatric patients over 67 attempts.
- Survival to hospital admission was observed in 17 of 36 (47.2%) patients.
- The straight blade was used in 56.8% of cases.
Conclusions:
- Paramedics can achieve high success rates in pediatric endotracheal intubation, similar to those in adult patients.
- The findings support the integration of pediatric endotracheal intubation into paramedic practice.
- This capability can enhance emergency care for critically ill or injured children in prehospital settings.
Abstract:
There are little data available on success rates, complications, and efficacy of intubation in the pediatric age group by prehospital personnel. In a 12-month period, paramedics successfully intubated 32 of 36 (88.9%) patients for various indications, with a total of 67 attempts. Seventeen of 36 (47.2%) patients survived to hospital admission. Patient age ranged from newborn to 14 years. Paramedics used the straight blade in 21 of 37 patients (56.8%). The study demonstrates that paramedics can intubate pediatric patients with the same success rate as in adult patients. The data support the inclusion of pediatric endotracheal intubation in the scope of paramedic practice.