Charles E Cady1, Ronald G Pirrallo. 1. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. cecady@mcw.edu
Abstract
OBJECTIVE: To determine the change in number of endotracheal intubations per paramedic after the implementation of Combitube use and to explore consequences. METHODS: Before-and-after study; urban/suburban EMS system; population 1 million. Number of patients 16 years and older, type of airway used, attempts, and successes were abstracted for time periods before and after the use of Combitubes. The number of endotracheal intubations/paramedic for each period was calculated. RESULTS: Three-year pre-Combitube: patients 50983; 6.6% arrests; 3142 received an endotracheal intubation attempt with 93.5% success. The average annual number of paramedics was 153 with 6.9 +/- 6.4 intubations per paramedic per year. Three-year post-Combitube: patients 55959; 6.0% arrests; 2913 received an advanced airway attempt: 860 Combitubes, success 89.4%; 2144 endotracheal intubations, success 91.6% (95% confidence interval success rate difference, 0.5-3.3; P = .007). The average annual number of paramedics was 177 with 3.7 +/- 3.3 intubations per paramedic per year. CONCLUSION: After implementation of the Combitube, the number of endotracheal intubation attempts/paramedic and success rates decreased.
OBJECTIVE: To determine the change in number of endotracheal intubations per paramedic after the implementation of Combitube use and to explore consequences. METHODS: Before-and-after study; urban/suburban EMS system; population 1 million. Number of patients 16 years and older, type of airway used, attempts, and successes were abstracted for time periods before and after the use of Combitubes. The number of endotracheal intubations/paramedic for each period was calculated. RESULTS: Three-year pre-Combitube: patients 50983; 6.6% arrests; 3142 received an endotracheal intubation attempt with 93.5% success. The average annual number of paramedics was 153 with 6.9 +/- 6.4 intubations per paramedic per year. Three-year post-Combitube: patients 55959; 6.0% arrests; 2913 received an advanced airway attempt: 860 Combitubes, success 89.4%; 2144 endotracheal intubations, success 91.6% (95% confidence interval success rate difference, 0.5-3.3; P = .007). The average annual number of paramedics was 177 with 3.7 +/- 3.3 intubations per paramedic per year. CONCLUSION: After implementation of the Combitube, the number of endotracheal intubation attempts/paramedic and success rates decreased.
Authors: Henry E Wang; David K Prince; Shannon W Stephens; Heather Herren; Mohamud Daya; Neal Richmond; Jestin Carlson; Craig Warden; M Riccardo Colella; Ashley Brienza; Tom P Aufderheide; Ahamed H Idris; Robert Schmicker; Susanne May; Graham Nichol Journal: Resuscitation Date: 2016-02-02 Impact factor: 5.262