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Prehospital Pediatric Endotracheal Intubation: A Survey of the United States

Published online by Cambridge University Press:  28 June 2012

Samuel J. Stratton*
Affiliation:
Los Angeles County EMS Agency, Torrance, Calif.
Luanne A. Underwood
Affiliation:
Los Angeles County EMS Agency, Torrance, Calif.
Sharon M. Whalen
Affiliation:
Lifeflight of Southern California, Long Beach, Calif.
Carol S. Gunter
Affiliation:
Los Angeles County EMS Agency, Torrance, Calif.
*
Emergency Dept., Bldg. D-9, LAC Harbor–UCLA Medical Center, 1000 W. Carson St., P. O. Box 2910, Torrance, CA 90509USA

Abstract

Introduction:

The standard of practice and teaching for prehospital pediatric endotracheal intubation (PETI) in the United States currently is unknown. The accepted practice of prehospital PETI is of interest because it has contradictory support in the medical literature.

Hypothesis:

PETI is an accepted method of prehospital airway control in the United States.

Methods:

Nationwide mail survey (June 1991 to March 1992) of each state emergency medical service (EMS) agency and all known paramedic training sites.

Results:

The use of PETI is supported by 100% of state EMS agencies and the American Virgin Islands. Ninety-seven percent (339 of 349) of the responding (349 of 523) paramedic training sites reported that PETI was taught in their programs. The results of the survey did not identify a predominate method for instructing paramedics in PETI. Lectures, mannequins, operating room demonstration, animal models, and cadavers were used in various ways for teaching the skill.

Conclusion:

Endotracheal intubation is an accepted standard in prehospital pediatric care. This standard exists with marginal support in published literature and study of prehospital PETI is needed to define the benefits, risks, and optimal instruction methods for the procedure.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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References

1. Emergency Cardiac Care Committee and Subcommittees, American Heart Association: Guidelines for cardiopulmonary resuscitation and emergency cardiac care, VI pediatric advanced life support. JAMA 1992;268:22622275.Google Scholar
2. Losek, JD, Hennes, H, Glaeser, P et al. : Prehospital care of the pulseless, nonbreathing pediatric patient. Am J Emerg Med 1987;5:370374.CrossRefGoogle ScholarPubMed
3. Aijian, P, Tsai, A, Knopp, R, Kallsen, GW: Endotracheal intubation of pediatric patients by paramedics. Ann Emerg Med 1989;18:489494.CrossRefGoogle ScholarPubMed
4. Pointer, JE: Clinical characteristics of paramedics performance of pediatric endotracheal intubation. Am J Emerg Med 1989;7:364366.Google ScholarPubMed
5. Losek, JD, Bonadio, WA, Walsh-Kelly, C et al. : Prehospital pediatric endotracheal intubation performance review. Ped Emerg Care 1989;5:14.CrossRefGoogle ScholarPubMed
6. Nakayama, DK, Gardner, MJ, Rowe, MI: Emergency endotracheal intubation in pediatric trauma. Ann Surg 1990;211:218223.CrossRefGoogle ScholarPubMed
7. Applebaum, D: Advanced prehospital care for pediatric emergencies. Ann Emerg Med 1985;14:656659.CrossRefGoogle ScholarPubMed
8. Eckenhoff, JE: Some anatomic considerations of the infant anesthesia larynx influencing endotracheal anesthesia. Anesthesiology 1951;12:401410.CrossRefGoogle ScholarPubMed
9. Toporek, CD: 1989 paramedic training sites, JEMS 1989;14:515530.Google ScholarPubMed
10. Quan, L, Wentz, KR, Gore, EJ, Copass, MK: Outcome and predictors of outcome in pediatric submersion victims receiving prehospital care in King County, Washington. Pediatrics 1990;86:586593.CrossRefGoogle ScholarPubMed
11. Stewart, R, Paris, PM, Pelton, GH, Garretson, D: Effect of varied training techniques on field endotracheal intubation success rates. Ann Emerg Med 1984;13:6973.CrossRefGoogle ScholarPubMed
12. Eisenberg, M, Bergner, L, Hallstrom, A: Epidemiology of cardiac arrest and resuscitation in children. Ann Emerg Med 1983;12:672674.CrossRefGoogle ScholarPubMed