Evaluation of Airway Management Proficiency in Pre-Hospital Emergency Setting; a Simulation Study

Area of Science:

• Emergency Medicine
• Medical Simulation
• Airway Management

Background:

• Emergency Medical Technicians (EMTs) face skill degradation due to infrequent exposure to critically ill patients requiring airway management.
• Low exposure can negatively impact performance in critical procedures like Endotracheal Intubation (ETI).

Purpose of the Study:

• To evaluate airway management skills in simulated pre-hospital emergency settings.
• To identify factors influencing the success rate of Endotracheal Intubation (ETI) by EMTs.

Main Methods:

• A simulation study involving active EMTs in pre-hospital emergency bases.
• Participants performed airway management scenarios in an ambulance setting.
• Univariate and multivariate regression analyses were used to identify factors affecting ETI success (≤3 attempts).

Main Results:

• The study included 184 EMTs with a median of 8 years of work experience.
• Overall success rates for ventilation, intubation, and backup airway were approximately 50%.
• EMTs successfully performed ETI within 3 attempts in 58.2% of cases. The number of previous ETIs performed was the most significant factor influencing success.

Conclusions:

• The success rate for Endotracheal Intubation (ETI) among EMTs in simulated pre-hospital settings is low.
• Improving modifiable factors, such as increasing the frequency of ETI procedures and gaining experience in realistic conditions, is essential.
• Enhanced training and practice are necessary to improve EMTs' airway management skills and patient outcomes.