Effect of Patient and Paramedic Positioning on Endotracheal Intubation Success in the Field
- 1 minVariable success rates have been reported for endotracheal intubation (ETI) by paramedics in field settings. ETI in the field presents unique challenges including patient location and the position the paramedic must assume to make the intubation attempt. Clinical and patient care experts with the City of Pittsburgh Emergency Medical Service investigated the effect of patient and paramedic positioning on ETI success rates on patients in the field. The hypothesis was that paramedics would have higher ETI success rates intubating patients outside the ambulance than inside and with the patient in a supine position with the paramedic prone compared to other positions.
I assisted in the data analysis and visualization of this study, which examined ETI attempts on about 400 patients between 2017 and 2019. Specifically, we retrospectively reviewed the electronic patient care reports documented after patient contacts and airway surveys completed by the 161 paramedics.
While limitations included the self-reporting of data, the analysis concluded that patients were successfully intubated at a significantly higher rate with the paramedic assuming a prone position when the patient was supine on the ground or floor. Patients were also successfully intubated at a significantly higher rate when the patient was inside, rather than outside, the ambulance. This contrasts with previous studies, which indicated a higher rate of success outside of an ambulance. This study has implications for paramedic training and education, and its conclusions were presented in a posted at the National Association of Physicians annual conference in January, 2020.
Header image source: The National Association of EMS Physicians.
Tom Goode
Data Scientist & EMS Researcher