PEDIATRIC INTUBATION

Abstract

The headline "Don't Intubate for Peds Emergencies" (News, May), is inappropriate, and the article overstates the conclusions of the study from Journal of the American Medical Association. Gausche and colleagues' work raises a number of valuable questions about pediatric endotracheal intubation (ETI).1 They conclude that "these results call into question the current practice of paramedics intubating children in an urban, out-of-hospital setting...." Your headline implies that pediatric intubation is never useful. This contradicts both your article and the JAMA article, which suggest that pediatric ETI be delayed until hospital arrival and contradict the American Heart Association's description of intubation as "the most effective and reliable method of assisting ventilation."2 Your statement describing the hospital as "the ideal place to perform intubation" is without clear support in the JAMA article or the Pediatric Advanced Life Support guideline.2 In fact, a JAMA editorialist wonders "if (the incident) study were repeated in the emergency departments... would the results be different?"3 The study's authors are careful to highlight that patients were seen in "suburban-urban, rapid-transport EMS systems," observing that "our conclusions may not be valid for rural environments or for EMS systems with prolonged transport times."1 The accompanying editorial reminds readers that "to conclude that out-of-hospital ETI for children should not be performed in any [EMS] system based on the single study is premature."3 AJN's efforts to provide nurses with thought-provoking information from the entire health care continuum are commendable. However, the Journal must exercise caution when summarizing complex research. Michael A. Frakes, BSN, CFRN, EMTP Hartford, CT Tracy Evans, MPH, MS, ACNP, CEN, EMTP Norwalk, CT