• Yumiko Okazaki, Shinji Kusunoki, and Masashi Kawamoto.
• Departments of Anesthesiology and Critical Care, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551.
• Masui. 2011 Jun 1; 60 (6): 757-62.

BackgroundFive years have passed since out-of-hospital tracheal intubation training for advanced level ambulance crews (emergency life saving technicians: ELSTs) was started in Japan. Herein, we reviewed results of the initial training and reeducation program.MethodsUsing a questionnaire sent by post, we surveyed out-of-hospital tracheal intubations performed by 19 ELSTs trained at Hiroshima University Hospital.Results And ConclusionsSixty-three tracheal intubations were attempted between 2004 and 2009, of which 56 (89%) were successful and 7 (11%) unsuccessful, with ventilation maintained using another means such as a laryngeal mask airway or bag-valve-mask in the latter cases. Esophageal intubation occurred in 6 cases, but were immediately recognized and dealt with appropriately. Only 1 failed intubation patient, in whom esophageal intubation was changed to bag-valve-mask ventilation, survived until discharge. The average number of yearly intubation attempts (1.2) was small, thus nearly all ELSTs replied that they desired a reeducation program to maintain their intubation skills. Furthermore, some expressed a preference to receive reeducation under conditions close to actual emergency settings. That latter finding reflects the difficulty of out-of-hospital tracheal intubation performed in adverse conditions, such as in inappropriate patient or rescuer positions, and secretion or bleeding in the oral cavity.

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