CARING FOR THE CRITICALLY ILL PATIENT Effect of Out-of-Hospital Pediatric Endotracheal Intubation on Survival and Neurological Outcome A Controlled Clinical Trial

Abstract

ALTHOUGH BAG-VALVE-MASK ventilation (BVM) and endotracheal intubation (ETI) are both widely used in the outof-hospital setting in caring for critically ill or injured children, there has been no controlled study comparing the outcomes of pediatric or adult patients treated with these 2 procedures. In 1 out-of-hospital study, BVM did compare favorably to non-ETI advanced airway management techniques (pharyngeal tracheal lumen, laryngeal mask, and esophageal tracheal combination esophageal-tracheal tube) among adults and children, as measured by PO2 and PCO2 values on arrival in the emergency department (ED), frequency of vomiting, and patient outcome. There have been a number of descriptive studies of ETI in the out-of-hospital setting. Reported success rates of pediatricETIvaryfrom50%to100%,depending on the patient’s presenting illness or injury, the age of the patient, education level of the health care provider, and use of neuromuscular blocking agents to facilitateintubation.Majorcomplications of ETI, such as esophageal intubation, havebeenreportedinas littleas1.8%and as many as 17% of pediatric patients in theout-of-hospital setting. Onestudy reported an overall complication rate of 22.6%,usingsuccinylcholinetofacilitate intubation. Despite the fact that retrospective studies comparing the survival ofpatientstreatedwithBVMandETIhave generally found no difference, some investigators have suggested that ETI may

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Cite this paper

@inproceedings{Gausche2000CARINGFT, title={CARING FOR THE CRITICALLY ILL PATIENT Effect of Out-of-Hospital Pediatric Endotracheal Intubation on Survival and Neurological Outcome A Controlled Clinical Trial}, author={Marianne Gausche}, year={2000} }