Skip to main content
SpringerLink
Log in
Book cover

Annual Update in Intensive Care and Emergency Medicine 2015 pp 155–166Cite as

Prehospital Endotracheal Intubation: Elemental or Detrimental?

  • Chapter

  • 2517 Accesses

Part of the book series: Annual Update in Intensive Care and Emergency Medicine 2015 ((AUICEM,volume 2015))

Abstract

Modern out-of-hospital emergency medical services (EMS) systems, as we have come to recognize them today, were established in the 1960s and 1970s when a cadre of intrepid physicians ventured into the streets and later published their successful experiences with lifesaving approaches to managing acute coronary syndromes, trauma care, and cardiopulmonary arrest on-scene [1–3].

Although physician-staffed ambulance services had been in place in many venues worldwide for more than a century, the late 20th century evolution of prehospital care was highlighted by documentation of life-saving outcomes in those first modern EMS programs and their use of invasive ‘advanced life support’ (ALS) procedures including prehospital endotracheal intubation (ETI) and intravascular (i.v.) cannulation for drug administration [1–3]. These life-saving reports helped to propel the widespread adoption of EMS systems and the concomitant introduction of specially-trained (non-physician) emergency medical technicians called ‘paramedics’ [1–5]. Eventually nursing personnel also ventured into the realm of on-scene emergency response, particularly in the arena of air medical services.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Pantridge JF, Geddes JS (1967) A mobile intensive care unit in the management of myocardial infarction. Lancet 290:271–273

    Article  Google Scholar 

  2. Cobb LA, Alvarez H, Copass MK (1976) A rapid response system for out-of-hospital cardiac emergencies. Med Clin North Am 60:283–293

    CAS  PubMed  Google Scholar 

  3. McManus WF, Tresch DD, Darin JC (1977) An effective prehospital emergency system. J Trauma 17:304–310

    Article  CAS  PubMed  Google Scholar 

  4. Jacobs LM, Berrizbeitia LD, Bennett B, Madigan C (1983) Endotracheal intubation in the prehospital phase of emergency medical care. JAMA 250:2175–2177

    Article  CAS  PubMed  Google Scholar 

  5. Pepe PE, Copass MK, Joyce TH (1985) Prehospital endotracheal intubation: rationale for training emergency medical personnel. Ann Emerg Med 14:1085–1092

    Article  CAS  PubMed  Google Scholar 

  6. Stewart RD, Paris P, Winter PM et al (1984) Field endotracheal intubation by paramedical personnel: success rates and complications. Chest 85:341–345

    Article  CAS  PubMed  Google Scholar 

  7. Copass MK, Oreskovich MR, Blaedogroen MR, Carrico CJ (1984) Prehospital cardiopulmonary resuscitation of the critically injured patient. Am J Surg 148:20–24

    Article  CAS  PubMed  Google Scholar 

  8. Durham LA, Richardson RJ, Wall MH, Pepe PE, Mattox KL (1992) Emergency center thoracotomy: impact of prehospital resuscitation. J Trauma 32:775–779

    Article  PubMed  Google Scholar 

  9. Miller JD, Sweet RC, Narayan R, Becker DP (1978) Early insults to the injured brain. JAMA 240:439–442

    Article  CAS  PubMed  Google Scholar 

  10. Page JO (1979) The paramedics: an illustrated history of paramedics in their first decade in the U.S.A. Backdraft Publications, Morristown, New Jersey, USA, pp 1–179

    Google Scholar 

  11. American College of Surgeons Committee on Trauma (1997) Advanced trauma life support program for physicians, 6th edn. American College of Surgeons, Chicago, pp 21–124 (Chapters 1–3)

    Google Scholar 

  12. Pepe PE, Copass MK, Fowler RL, Racht EM (2009) Medical direction of emergency medical services systems. In: Cone DC, Fowler R, O’Connor RE (eds) Textbook of the National Association of EMS Physicians. Kendall Hunt Publications, Dubuque, Iowa, USA, pp 22–52

    Google Scholar 

  13. Warner KJ, Carlbom D, Cooke CR, Bulger EM, Copass MK, Sharar SR (2010) Paramedic training for proficient prehospital endotracheal intubation. Prehospital Emerg Care 14:103–108

    Article  Google Scholar 

  14. Sirbaugh PE, Pepe PE, Shook JE et al (1999) A prospective, population-based study of the demographics, epidemiology, management and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med 33:174–184

    Google Scholar 

  15. Winchell RJ, Hoyt DB (1997) Endotracheal intubation in the field improves survival in patients with severe head injury. Arch Surg 132:592–597

    Article  CAS  PubMed  Google Scholar 

  16. Eckstein M, Chan L, Schneir A, Palmer R (2000) The effect of prehospital advanced life support on outcomes of major trauma patients. J Trauma 48:643–648

    Article  CAS  PubMed  Google Scholar 

  17. Hasegawa K, Hiraide A, Chang Y, Brown DF (2013) Association of prehospital advanced airway management with neurologic outcome and survival in patients with out-of-hospital cardiac arrest. JAMA 309:257–66

    Article  CAS  PubMed  Google Scholar 

  18. Holmberg M, Holmberg S, Herlitz J (2002) Low chance of survival among patients requiring adrenaline (epinephrine) or intubation after out-of-hospital cardiac arrest in Sweden. Resuscitation 54:37–45

    Article  PubMed  Google Scholar 

  19. Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR (2009) Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation 119:1484–1491 (for the Resuscitation Outcomes Consortium)

    Article  PubMed Central  PubMed  Google Scholar 

  20. Hanif MA, Kaji AH, Niemann JT (2010) Advanced airway management does not improve outcome of out-of-hospital cardiac arrest. Acad Emerg Med 17:926–931

    Article  PubMed  Google Scholar 

  21. Key CB, Pepe PE, Sirbaugh PE, Shook JE, Kimball KT (1996) Does endotracheal intubation affect outcome in out-of-hospital pediatric cardiac arrest? Acad Emerg Med 3:404–405

    Google Scholar 

  22. Wang HE, Yealy DM (2006) Out-of-hospital endotracheal intubation: where are we? Ann Emerg Med 47:532–541

    Article  PubMed  Google Scholar 

  23. Strote J, Roth R, Cone DC, Wang HE (2009) Prehospital endotracheal intubation: the controversy continues. Am J Emerg Med 27:1142–1147

    Article  PubMed  Google Scholar 

  24. Lossius HM, Sollid SJM, Rehn M, Lockey DJ (2011) Revisiting the value of pre-hospital tracheal intubation: an all-time systematic literature review extracting the Utstein airway core variables. Crit Care 15:R26

    Article  PubMed Central  PubMed  Google Scholar 

  25. Davis DP, Hoyt DB, Ochs M et al (2003) The effect of paramedic rapid sequence intubation on outcome in patients with severe traumatic brain injury. J Trauma 54:444–453

    Article  PubMed  Google Scholar 

  26. Gausche M, Lewis RJ, Stratton S et al (2000) Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome. JAMA 283:783–790

    Article  CAS  PubMed  Google Scholar 

  27. Pepe PE, Eckstein M (1998) Reappraising the prehospital care of the patient with major trauma. Emerg Med Clin N Am 16:1–15

    Article  CAS  Google Scholar 

  28. Katz SH, Falk JL (2001) Misplaced endotracheal tubes by paramedics in an urban emergency medical services systems. Ann Emerg Med 37:32–37

    Article  CAS  PubMed  Google Scholar 

  29. Wang HE, Kupas DF, Paris PM et al (2003) Preliminary experience with a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation. Resuscitation 58:49–58

    Article  PubMed  Google Scholar 

  30. Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J (2009) Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation 120:1241–1247

    Article  PubMed Central  PubMed  Google Scholar 

  31. Bobrow BJ, Clark LL, Ewy G et al (2008) Minimally interrupted cardiac resuscitation. JAMA 299:1158–1165

    Article  CAS  PubMed  Google Scholar 

  32. Curka PA, Pepe PE, Ginger VF, Ivy MV, Sherrard RC, Zachariah BS (1993) Emergency medical services priority dispatch. Ann Emerg Med 22:1688–1695

    Article  CAS  PubMed  Google Scholar 

  33. Stout J, Pepe PE, Mosesso VN (2000) All-advanced life support versus tiered-response ambulance systems. Prehospital Emerg Care 4:1–6

    Article  CAS  Google Scholar 

  34. Pepe PE, Zachariah BS, Chandra N (1993) Invasive airway techniques in resuscitation. Ann Emerg Med 22(Part II):393–403

    Article  CAS  PubMed  Google Scholar 

  35. Silvestri S, Ralls G, Krauss B et al (2005) The effectiveness of out-of-hospital use of continuous end-tidal carbon dioxide monitoring on the rate of unrecognized misplaced intubation within a regional emergency medical service system. Ann Emerg Med 45:497–503

    Article  PubMed  Google Scholar 

  36. Burton JH, Baumann MR, Maoz T et al (2003) Endotracheal intubation in a rural state: Procedure utilization and impact of skills maintenance guidelines. Prehospital Emerg Care 7:352–356

    Article  Google Scholar 

  37. Pepe PE, Lurie KG, Wigginton JG, Raedler C, Idris AH (2004) Detrimental hemodynamic effects of assisted ventilation in hemorrhagic states. Crit Care Med 32(Suppl):414–420

    Article  Google Scholar 

  38. Aufderheide TP, Sigurdsson G, Pirrallo RG et al (2004) Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation 109:1960–1965

    Article  PubMed  Google Scholar 

  39. Roppolo LP, Wigginton JG, Pepe PE (2004) Emergency ventilatory management as a detrimental factor in resuscitation practices and clinical research efforts. In: Vincent JL (ed) 2004 Intensive Care and Emergency Medicine. Springer-Verlag, Berlin, pp 139–151

    Google Scholar 

  40. Bernhard M, Becker TK, Böttiger BW (2013) Prehospital airway management for out-of-hospital cardiac arrest. JAMA 309:1888

    Article  CAS  PubMed  Google Scholar 

  41. Wang HE, Balasubrami GK, Lave JR et al (2009) Paramedic endotracheal intubation experience improves patient survival. Prehosp Emerg Care 19:90–91

    Google Scholar 

  42. Helm M, Hossfeld B, Schafer S, Hoitz J, Lampl L (2005) Factors influencing emergency intubation in the pre-hospital setting – a multicentre study in the German helicopter emergency medical service. Br J Anaesthesia 96:67–71

    Article  Google Scholar 

  43. Jensen JL, Cheung KW, Tallon JM, Travers AH (2010) Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review. Can J Emerg Med 12:135–40

    Google Scholar 

  44. Wang HE, Szydlo D, Stouffer JA, Lin S, Carlson JN, Vaillancourt C (2012) Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest. Resuscitation 83:1061–1066

    Article  PubMed Central  PubMed  Google Scholar 

  45. Pepe PE, Mattox KL, Fischer RP, Matsumoto CM (1990) Geographical patterns of urban trauma according to mechanism and severity of injury. J Trauma 30:1125–1132

    Article  CAS  PubMed  Google Scholar 

  46. Persse DE, Key CB, Bradley RN et al (2003) Cardiac arrest survival as a function of ambulance deployment strategy in a large urban medical services system. Resuscitation 59:97–104

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    P. E. Pepe, L. P. Roppolo & R. L. Fowler

  2. The Parkland Health and Hospital System, Dallas County, USA

    P. E. Pepe, L. P. Roppolo & R. L. Fowler

Authors
  1. P. E. Pepe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. P. Roppolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. L. Fowler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. E. Pepe .

Editor information

Editors and Affiliations

  1. Université libre de Bruxelles, Dept. of Intensive Care, Erasme Hospital, Brussels, Belgium

    Jean-Louis Vincent Prof.

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland and BioMed Central Ltd.

About this chapter

Cite this chapter

Pepe, P.E., Roppolo, L.P., Fowler, R.L. (2015). Prehospital Endotracheal Intubation: Elemental or Detrimental?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2015. Annual Update in Intensive Care and Emergency Medicine 2015, vol 2015. Springer, Cham. https://doi.org/10.1007/978-3-319-13761-2_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13761-2_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13760-5

  • Online ISBN: 978-3-319-13761-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation