Format

Send to:

Choose Destination
See comment in PubMed Commons below
JAMA. 2000 Feb 9;283(6):783-90.

Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: a controlled clinical trial.

Author information

  • 1Department of Emergency Medicine, Harbor-UCLA Medical Center, and Harbor-UCLA Research and Education Institute, Torrance, Calif 90509, USA. mgausche@emedharbor.edu

Erratum in

  • JAMA 2000 Jun 28;283(24):3204.

Abstract

CONTEXT:

Endotracheal intubation (ETI) is widely used for airway management of children in the out-of-hospital setting, despite a lack of controlled trials demonstrating a positive effect on survival or neurological outcome.

OBJECTIVE:

To compare the survival and neurological outcomes of pediatric patients treated with bag-valve-mask ventilation (BVM) with those of patients treated with BVM followed by ETI.

DESIGN:

Controlled clinical trial, in which patients were assigned to interventions by calendar day from March 15, 1994, through January 1, 1997.

SETTING:

Two large, urban, rapid-transport emergency medical services (EMS) systems.

PARTICIPANTS:

A total of 830 consecutive patients aged 12 years or younger or estimated to weigh less than 40 kg who required airway management; 820 were available for follow-up.

INTERVENTIONS:

Patients were assigned to receive either BVM (odd days; n = 410) or BVM followed by ETI (even days; n = 420).

MAIN OUTCOME MEASURES:

Survival to hospital discharge and neurological status at discharge from an acute care hospital compared by treatment group.

RESULTS:

There was no significant difference in survival between the BVM group (123/404 [30%]) and the ETI group (110/416 [26%]) (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.61-1.11) or in the rate of achieving a good neurological outcome (BVM, 92/404 [23%] vs ETI, 85/416 [20%]) (OR, 0.87; 95% CI, 0.62-1.22).

CONCLUSION:

These results indicate that the addition of out-of-hospital ETI to a paramedic scope of practice that already includes BVM did not improve survival or neurological outcome of pediatric patients treated in an urban EMS system.

PMID:
10683058
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Write to the Help Desk