Paramedic intubation training in a pediatric operating room

Abstract

The authors conducted a prospective study to assess the performance of paramedics with prior adult endotracheal intubation experience in pediatric intubation in the operating room of a teaching hospital. Nineteen paramedic studients were observed attempting endotracheal intubation on a total of 57 anesthetized pediatric patients undergoing scheduled surgical procedures. The average age of patients was 5.1 years (range, 6 months to 15.2 years). Average duration of intubation attempts was 22.7 ± 10.7 seconds, with a success rate on first attempt of 74%. Only minor complications occurred, and were limited to intubation attempts of greater than 45 seconds duration in four cases (6%), and patient oxygen saturation <90% in one case (2%). The study suggests that paramedics may be successfully incorporated into a hospital's clinical training program, and can receive closely supervised experience in pediatric endotracheal intubation without compromising patient care. Such training may increase the willingness of paramedics to attempt emergent prehospital endotracheal intubation of children, as well as increase their success with this potentially life-saving procedure.