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February 18, 2010
Study: Experience matters in out-of-hospital intubation
Reuters Health Medical News
NEW YORK — Experience matters for out-of-hospital intubation during a cardiac arrest or a medical illness, a new study shows, with patient survival linked to the volume of procedures the rescuer has done in the past.
In general, experience didn't seem to matter for out-of-hospital intubation of heart-beating trauma patients, but it did make a difference for certain subsets, its authors say.
According to the report in the February 8th online issue of the Annals of Emergency Medicine, cardiac arrest patients treated by a very experienced rescuer (>50 intubations) were 48% more likely to survive than those treated by a rescuer with low experience (1 to 10 intubations).
With medical non-arrest patients, the corresponding benefit was 55%.
To assess how out-of-hospital intubation experience affects patient outcomes, Dr. Henry E. Wang, from the University of Alabama at Birmingham, and colleagues analyzed data from Pennsylvania's statewide emergency medicine database.
Tracheal experience was defined as cumulative tracheal intubation from 2000 to 2005.
The study involved 4846 rescuers who intubated 33,117 patients between 2003 and 2005, including 21,753 in cardiac arrests, 8162 heart-beating patients with medical illnesses, and 3202 heart-beating trauma victims.
While the overall analysis showed no effect of rescuer experience on survival of trauma patients who were not in cardiac arrest, analysis by the type of emergency care did.
Specifically, the authors found that among trauma patients treated by non-urban emergency services, survival odds did improve as rescuer experience improved.
Outside of urban areas, trauma patients treated by very experienced rescuers were nearly six times more likely to survive than those treated by rescuers with little experience.
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