Prehospital endotracheal intubation practices by paramedics in the provincial ambulance service of the Western Cape province of South Africa

Master Thesis

2006

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University of Cape Town

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Abstract
It is well-established that endotracheal intubation in the field is associated with a considerably greater degree of difficulty, and a much higher complication and failure rate than intubation undertaken in the operating-theatre environment. The reasons for this are many-fold, have been quantified and discussed in detail. This study assesses the difficulties encounteed by paramedics in the field, by identifying factors contributing to difficult and failed intubation, by quantifying the incidence of difficult and failed intubations, by assessing and describing the incidence of complications and adverse outcomes, and by assessing the impact of the procedure on patient care. This dissertation includes a comprehensive international literature review of studies related to prehospital endotracheal intubation, and discusses and compares these published findings to the results obtained from this study. Furthermore, this study provides feedback to paramedics, paramedic-educators and managers, by offering a comprehensive strategy for improvement in the procedure of field intubation, with a view to increased safety, ease of execution, and improved patient outcome.
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Includes bibliographical references (leaves 76-79).

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