Field intubation of trauma patients: complications, indications, and outcomes

Neither the success nor the complication rate for field intubation of trauma patients is known with any certainty. A retrospective audit of 94 severely injured patients who required field intubation was undertaken. Fifty percent (13 of 26) of survivors and 67% (37 of 71) of nonsurvivors were successfully intubated in the field (not significant). Mechanism of injury was similar in both groups, but survivors were younger (27 v 60 years, P= .049) and less critically injured, as reflected by their Injury Severity Scale scores, their Trauma Scores, and their field Glasgow Coma Scale scores (22.1 v 30.8, P = .0035; 7.7 v 4.2, P < .0002; and 6.3 v 3.3, P < .0001). When compared with previously published studies of medical patients with cardiac arrest, the success rate was lower in our trauma patients. When compared with patients having similar injuries intubated at the trauma center, field intubation was three times more likely to be associated with the development of nosocomial pneumonia than was hospital intubation.