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Study casts doubt on value of emergency breathing procedure


For more than 20 years, paramedics in Britain have performed emergency intubation (passing a breathing tube into the windpipe to deliver oxygen to the lungs of trauma patients) without using anaesthesia. Yet a study in this week's BMJ finds that less than one per cent of these patients survive, casting serious doubt on the value of this practice.

Over a six year period, researchers at the Royal London Hospital identified trauma patients who had been intubated outside hospital and without the use of drugs by paramedics or doctors. Of 486 patients, one survived to hospital discharge.

Even in parts of the United States, where it is standard practice for paramedics and nurses to use drugs to facilitate prehospital intubation, failed intubation rates can be high, say the authors.

As almost all the trauma patients intubated without the use of drugs died, the value of this practice is doubtful and deserves further scrutiny, conclude the authors.


Gareth Davies, Consultant in Accident and Emergency and Prehospital Care, Royal London Hospital, London, UK

Survival of trauma patients who have prehospital tracheal intubation without anaesthesia or muscle relaxants: observational study BMJ Volume 323, p 141

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