Survey of Out-of-hospital Emergency Intubations in the French Prehospital Medical System: A Multicenter Study☆,☆☆,★
Section snippets
INTRODUCTION
Emergency endotracheal intubation (ETI) is a lifesaving technique with which all emergency physicians should be familiar.1 Although ETI in Anglo-Saxon prehospital EMS system has been studied,2, 3, 4, 5, 6, 7, 8, 9, 10, 11 there are few studies of field ETI performed by the French prehospital emergency medical system.12 The French prehospital emergency medical system, called SAMU (Service d’Aide Médicale Urgente), differs conceptually from Anglo-Saxon prehospital systems. For example, in France,
MATERIALS AND METHODS
In France, management of out-of-hospital emergencies is the responsibility of the SAMU. France is divided into 95 regional SAMUs organized as follows: 1 dispatching center with switchboard operators and 2 dispatching physicians situated in a major hospital covering a given medical region. SAMU is the equivalent of the Anglo-Saxon command center for the region. Universal access to SAMU is by telephone number 15, the national emergency call for help. Switchboard operators, available 24 hours a
RESULTS
During the 6 months of the study, 691 patients had out-of-hospital ETI. Questionnaires were completed for all patients, and no patient was excluded. The mean age (±SD) was 51.4±20.2 years, and the sex ratio (male:female) was 1.97.
Six hundred eighty-five patients (99.1%) were intubated successfully in the field. The median (25th; 75th percentiles) number of attempts for successful intubation was 1 (1;2) attempt. The rate of success was 68% for the first attempt and 21% for 2 attempts. The number
DISCUSSION
ETI is the definitive procedure for airway control and respiratory management. Over the past 20 years, several studies have evaluated prehospital ETI by paramedic providers in Anglo-Saxon advanced life support systems.2, 3, 4, 5, 6, 7, 8, 9, 10, 11 However, there are few detailed evaluations of ETI in the French prehospital medical system (SAMU), which relies on physician providers.12 Our study compares the performance of SAMU providers with published studies from other prehospital systems.
The
Acknowledgements
The authors acknowledge Nancy Flanagan for her grammatical correction of this manuscript.
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From the SAMU 93, CHU Avicenne, University Paris XIII; 93009 Bobigny Cedex* ; SMUR Lariboisiere, CHU Lariboisire, Paris‡ ; Department of Emergency Medicine, CWRU/MetroHealth Center, Cleveland, OH§ ; SMUR Delafontaine, Hôpital Delafontaine, 93205 Saint Denis∥ ; SMUR Aulnays, CHR Ballanger, 93600 Aulnays¶ ; SAMU 86, CHR Poitiers, 86000 Poitiers# ; SMUR Argenteuil, Hôpital d’Argenteuil, 95107 Argenteuil** ; SAMU 91, CHR Corbeil, 91100 Corbeil ; SMUR Montfermeil, CHI Montfermeil, 93370 Montfermeil‡‡ ; and SAMU Melun, CHR Melun, 77000 Melun,§§ France.
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Reprint no. 47/1/92760
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Address for reprints: Frédéric Adnet, MD, PhD, Service d’Aide Médicale Urgente (SAMU 93), CHU Avicenne, 125, rue de Stalingrad, 93009 Bobigny Cedex, France, +33-1-48-96-44-00, Telecopy: +33-1-48-96-44-45, E-mail [email protected]