Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Approximately 16,000 children are transported by ambulances each day, and there are an estimated 4,500 ambulance crashes each year. Information about emergency medical services (EMS) provider knowledge, opinions, and behaviors regarding occupant restraint is lacking. ⋯ This study indicates that the frequency of crashes in ambulances, and therefore the potential for injury, may be underappreciated. Current restraint practices of some of the study group are outside recommendations and may be placing at risk some children who are being transported by ambulances. This problem is complicated by the relative infrequency of pediatric ambulance transports compared with adults. Improved equipment and education may help providers safely transport pediatric patients. In addition, providers are risking their own safety by not wearing seatbelts in the rear ambulance compartment. Improved equipment may help alleviate this risk and allow providers to take care of patients safely.
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The rate of difficult intubation in prehospital emergency medicine varies greatly among studies already published and depends on several factors. The authors' objective was to determine the rate of difficult intubations and to determine factors associated with prehospital difficult airways when a standard protocol for sedation and intubation was applied. ⋯ If prehospital medical airway management is standardized and performed by trained operators, failure to intubate is rare (0.1%), and the incidence of difficult tracheal intubation is 7.4%, independent of cardiorespiratory status.