The following abstract was developed at the 2006 Research Summit and presented at the 2006 NAEMSE symposium.

When Can Paramedic Students Safely Perform Endotracheal Intubation?

Kent R. Spitler, MSEd, RN, NREMT-P; Kenneth J. Sternig, BSN, EMT-P; Ken L. Williams, MDIV, BS, CCEMTP, EMT-P; and Timothy P Howey, BA, NREMT-I

Introduction: The Paramedic National Standard Curriculum (PNSC) recommends that paramedic students successfully perform five live-patient endotracheal intubations (ETI) to ensure safe future performance. This recommendation is based on survey data and expert opinion.

Hypothesis: If paramedic students acquire ETI experience in a hospital setting, the current recommendation of five ETI successes is not adequate to ensure that students can safely perform subsequent field endotracheal intubations.

Methods: Data was collected between 2001 and 2005 from paramedic students participating in FISDAP, a national, online student tracking system. Students prospectively reported their clinical and field experiences. The investigators analyzed the data to determine if there is a correlation between hospital-based clinical ETI experience and the success rate of paramedic students’ initial ETI field attempt following clinical experience.

Results: A total of 890 students met the criteria. Students with 5 previous clinical ETI successes were only 2% more likely to successfully intubate during their first field attempt than students with 0 previous clinical successes. Additionally, students with no clinical ETI attempts and students with >90% clinical ETI successes had average success rates of 67 and 71% respectively on their first field ETIs (see Figure A).

Conclusion: In this group of subjects, the number of clinical ETI attempts/successes was not directly proportional to initial field ETI success rates. Similarly, no correlation exists between clinical ETI success rates and initial field ETI success rates following clinical experience. A study examining students’ continued field ETI success rates should be conducted, to determine if a trend emerges.