Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation

Abstract Background Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high t...

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Autores principales:	Silas Houghton Budd, Eleanor Alexander-Elborough, Richard Brandon, Chris Fudge, Scott Hardy, Laura Hopkins, Ben Paul, Sloane Philips, Sarah Thatcher, Paul Winsor
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Tracheal intubation Intubation Airway Paramedic Prehospital Critical care Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/0c8e8bc0ce54456cbae68550b19574ca
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spelling	oai:doaj.org-article:0c8e8bc0ce54456cbae68550b19574ca2021-11-21T12:14:31ZDrug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation10.1186/s12873-021-00533-01471-227Xhttps://doaj.org/article/0c8e8bc0ce54456cbae68550b19574ca2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00533-0https://doaj.org/toc/1471-227XAbstract Background Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high tracheal intubation success should continue to use it. Methods We conducted a retrospective service evaluation of all drug-free tracheal intubation attempts by specialist paramedics (critical care) from South East Coast Ambulance Service NHS Foundation Trust between 1st January and 31st December 2019. Our primary outcome was first-pass success rate, and secondary outcomes were success within two attempts, overall success, Cormack-Lehane grade of view, and use of bougie. Results There were 663 drug-free tracheal intubations and following screening, 605 were reviewed. There was a first-pass success rate of 81.5%, success within two attempts of 96.7%, and an overall success rate of 98.35%. There were ten unsuccessful attempts (1.65%). Bougie use was documented in 83.4% on the first attempt, 93.5% on the second attempt and 100% on the third attempt, Conclusion Specialist paramedics (critical care) are able to deliver drug-free tracheal intubation with good first-pass success and high overall success and are therefore both safe and competent at this intervention.Silas Houghton BuddEleanor Alexander-ElboroughRichard BrandonChris FudgeScott HardyLaura HopkinsBen PaulSloane PhilipsSarah ThatcherPaul WinsorBMCarticleTracheal intubationIntubationAirwayParamedicPrehospitalCritical careSpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Tracheal intubation Intubation Airway Paramedic Prehospital Critical care Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Tracheal intubation Intubation Airway Paramedic Prehospital Critical care Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Silas Houghton Budd Eleanor Alexander-Elborough Richard Brandon Chris Fudge Scott Hardy Laura Hopkins Ben Paul Sloane Philips Sarah Thatcher Paul Winsor Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
description	Abstract Background Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high tracheal intubation success should continue to use it. Methods We conducted a retrospective service evaluation of all drug-free tracheal intubation attempts by specialist paramedics (critical care) from South East Coast Ambulance Service NHS Foundation Trust between 1st January and 31st December 2019. Our primary outcome was first-pass success rate, and secondary outcomes were success within two attempts, overall success, Cormack-Lehane grade of view, and use of bougie. Results There were 663 drug-free tracheal intubations and following screening, 605 were reviewed. There was a first-pass success rate of 81.5%, success within two attempts of 96.7%, and an overall success rate of 98.35%. There were ten unsuccessful attempts (1.65%). Bougie use was documented in 83.4% on the first attempt, 93.5% on the second attempt and 100% on the third attempt, Conclusion Specialist paramedics (critical care) are able to deliver drug-free tracheal intubation with good first-pass success and high overall success and are therefore both safe and competent at this intervention.
format	article
author	Silas Houghton Budd Eleanor Alexander-Elborough Richard Brandon Chris Fudge Scott Hardy Laura Hopkins Ben Paul Sloane Philips Sarah Thatcher Paul Winsor
author_facet	Silas Houghton Budd Eleanor Alexander-Elborough Richard Brandon Chris Fudge Scott Hardy Laura Hopkins Ben Paul Sloane Philips Sarah Thatcher Paul Winsor
author_sort	Silas Houghton Budd
title	Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
title_short	Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
title_full	Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
title_fullStr	Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
title_full_unstemmed	Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation
title_sort	drug-free tracheal intubation by specialist paramedics (critical care) in a united kingdom ambulance service: a service evaluation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0c8e8bc0ce54456cbae68550b19574ca
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Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation

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