Quote:
Originally posted by ccrn
**RESULTS: Of 108 patients intubated in the prehospital setting, the ETT was found to be misplaced on assessment in the ED in 25% of cases (esophageal placement, 17%; hypopharyngeal placement, 8%). Fifty-six percent of the patients with esophageal ETTs and 33% of those with hypopharyngeal ETTs died in the ED. The rate of ETT misplacement was 37% in trauma patients compared with 14% in medical patients (p<0.01). Failure to detect ETCO2 on patient arrival at the ED was noted in all but one of the patients with esophageal ETTs (the one exception was a patient who was breathing spontaneously upon arrival), and in four of nine with hypopharyngeal ETTs, as well as 17% of the patients with correctly placed ETTS (all of whom were asystolic with no return of spontaneous circulation).
CONCLUSIONS: The alarmingly high rate of unrecognized ETT misplacement in the prehospital setting within this EMS system suggests a need for an evaluation of the scope of this problem in other communities. **
This is just one of many studies I found on a search. I wont even go into details of my own experiences working in ER recieving intubated pts from EMS.
This is not to say I do not respect them because I do, in fact I admire them.
But to say one would NOT benefit from continuing education under controlled environments from higher providers is remiss in my opinion.
My apologies for going off topic-
ccrn
|
\
can you give the citation for this abstract. I am guessing its old...from prior to CO2 detectors placed on most EMS trucks. -+