INTUBATION SUCCESS RATES IMPROVE FOR AN AIR MEDICAL PROGRAM AFTER IMPLEMENTING THE USE OF NEUROMUSCULAR BLOCKING-AGENTS

To determine whether the success rate for endotracheal intubation impr oves after implementing the use of neuromuscular blocking (NMB) agents in an air medical program, this retrospective study analyzed all pati ents requiring endotracheal intubation at two air medical programs (nu rse/paramedic crews) over a 5-year period. Air medical program A, the control group, had employed NMB agents throughout the entire study per iod. Air medical program B, which did not use NMB agents from July 1, 1989 through June 30, 1992, implemented their use starting July 1, 199 2. For program A, the overall intubation success rate was 93.5% (202 s uccessful intubations in 216 patients) and the successful intubations/ total attempts ratio was 0.67 (202 of 301). For program B, the overall intubation success rate improved from 66.7% (46 successful intubation s in 69 patients) before NMB agent use to 90.5% (57 in 63) after NMB a gent use (P = .001). The successful intubations/total attempts ratio i ncreased from 0.36 (51 of 141) prior to NMB agent use to 0.48 (63 of 1 32) after NMB agent use (P = NS). In comparing the 92 patients who did not receive NMB agents to the 40 patients who did, the intubation suc cess rate increased from 69.6% (64 of 92) to 97.5% (39 of 40) (P < .00 1) and the successful intubation/total attempts ratio increased from 0 .36 (73 of 202) to 0.58 (41 of 71) (P = .007). With the use of NMB age nts, program a's overall intubation success rate increased significant ly, matching the results of program A. Copyright (C) 1998 by W.B. Saun ders Company.