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Should ambulance crews perform emergency breathing procedure?

Prehospital tracheal intubation in severely injured patients: a Danish observational study BMJ Volume 327, pp 533-4

BMJ

A study in this week's BMJ questions whether ambulance crews can master the skills needed to provide emergency intubation (passing a breathing tube down the throat of severely injured patients) before they reach hospital.

Researchers in Denmark identified 220 severely injured patients who were intubated out of hospital by a mobile emergency care unit, staffed with an anaesthetist, between 1998 and 2000.

The mobile unit brought 172 of these patients to hospital, and 74 (43%) were intubated before reaching hospital. Of these, 62 (84%) received anaesthetics.

Thirty-six (58%) of patients who were given anaesthetics and one (8%) who were not survived at least six months. These results contrast with a study of the emergency helicopter service in London, which found intubation without drugs was hopeless.

The environment out of hospital is different from in hospital and support and resources are limited, say the authors. "We question whether anaesthesia and intubation of trauma patients can be mastered and routinely be maintained by ambulance personnel."

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