Paramedic-Training Challenges

Emergency medical researchers have found that many paramedics do not have enough clinical experience in the insertion of emergency breathing tubes in patients before arriving at a hospital, according to a study in the August 2005 issue of Critical Care Medicine.

Endotrachial intubation (ETI) is an emergency medical procedure performed to deliver oxygen into a patient's lungs. Using patient data over one year, researchers at the University of Pittsburgh School of Medicine (PA, USA) examined the frequency of intubation performed by paramedics. They found that two-thirds of paramedics performed intubation less than three times per year while 40% performed no intubations at all. Although the study showed that air medical and urban paramedics were exposed to slightly more intubation procedures, these differences were small.

Paramedic students in the United States are required to perform only five intubation procedures before graduation, compared to emergency medicine residents, who are required to perform 35, or anesthesiology residents, who must complete 50 before graduation. Prior studies of complex medical procedures have shown that the occurrence of errors, adverse events, and poor outcomes is associated with the volume of procedural experience.

"We need to find better ways to train paramedics to perform this very difficult procedure or find better and simpler ways to manage the airway,” said lead author Henry E. Wang, M.D., M.P.H., assistant professor of emergency medicine at the University of Pittsburgh School of Medicine.





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University of Pittsburgh School of Medicine