THE USE OF TRISS METHODOLOGY TO VALIDATE PREHOSPITAL INTUBATION BY URBAN EMS PROVIDERS

The purpose of this study was to determine the impact of field orotrac heal intubation (OI) by urban emergency medical technician-paramedics (EMT Ps) on outcome compared with trauma score and injury severity sco re (TRISS) expectations. The records of all trauma patients intubated by EMT-Ps or hospital personnel were abstracted for OI attempts/succes ses, use of neuromuscular blockade (NMB), scene time, discharge neurol ogical status, and hospital survival compared with TRISS. EMT-Ps attem pted 43% of all intubations; 81% were successful versus 98% by hospita l staff (P < .05), NMB was used by 76% of hospital intubations versus none by EMS (P < .05), Scene time was 10.3 +/- 3.2 minutes versus 11.6 +/- 2.1 for patients intubated by emergency medical services (EMS) an d hospital staff (P < .05). Sixty percent of patients intubated by EMS versus 68% by hospital staff had good/moderate discharge neurological status. Survival for patients intubated by EMS versus hospital staff was 11% and 40%, respectively, compared with 2% and 45% expected by TR ISS. Field OI by urban EMT-Ps has a favorable impact on survival with good neurological outcome (P < .05). Copyright (C) 1997 by W.B. Saunde rs Company.