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Characteristics of paediatric pre-hospital intubation by Intensive Care Paramedics

Tom Solan1,2,3,4, Daniel Cudini5,6,7, Matthew Humar5,6,7

  • 1Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|April 5, 2023
PubMed

Insights

Emergency intubation in children is challenging. This study found an 87.5% first-pass success rate for pediatric intubations by paramedics, highlighting the need for ongoing training.

Area of Science:

  • Pediatric Emergency Medicine
  • Paramedic Airway Management
  • Pre-hospital Care

Background:

  • Emergency intubation in children presents unique anatomical, physiological, and situational challenges.
  • Limited clinician exposure can increase the risk of adverse events during pediatric intubation.

Purpose of the Study:

  • To characterize pre-hospital pediatric intubations performed by Intensive Care Paramedics.
  • To analyze demographics and first-pass success rates of these procedures.

Main Methods:

  • Retrospective review of state-wide ambulance service electronic patient care records (ePCRs) in Victoria, Australia.
  • Analysis of children aged 0-18 years requiring advanced airway management over a 12-month period.

Main Results:

  • 78 cases required advanced airway management out of 2674 attended cases.
  • 87.5% of pediatric patients (68/78) were successfully intubated on the first attempt.
  • First-pass success was lowest in infants under 1 year of age; common indications included head injury and cardiac arrest.

Conclusions:

  • Pre-hospital pediatric intubation is infrequent, occurring in critically ill patients.
  • High-level paramedic training is essential for preventing adverse events and ensuring patient safety.
Abstract

Keywords:
airway managementemergency departmentintubationpaediatricpre-hospital

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