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Highly Accessed Letter

Training and experience are more important than the type of practitioner for intubation success

Pieter F Fouche1*, Paul M Middleton2 and Kristina M Zverinova1

Author Affiliations

1 Ambulance Service of New South Wales, Locked Bag 105, Rozelle NSW 2039, Australia

2 Discipline of Emergency Medicine, University of Sydney, Sydney, NSW 2006, Australia

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Critical Care 2013, 17:412  doi:10.1186/cc11924


See related research by Lossius et al., http://ccforum.com/content/16/1/R24

Published: 8 February 2013

First paragraph (this article has no abstract)

A meta-analysis by Lossius and colleagues demonstrated a higher endotracheal intubation (ETI) success rate for physicians compared with nonphysicians [1]. We re-analysed the data from Lossius and colleagues to investigate the relationship between the clinicians' levels of training and ETI success rates, utilising the 'Overview of included studies' spreadsheet published online as an additional file. We created a variable for a high level of ETI training taken from the 'extensively trained' description in the 'EMS manning' column. We assumed the physicians to also be highly trained in ETI, as they entirely comprised emergency physicians and anaesthesiologists. Our multivariate meta-regression analysis, adjusting for the training and the type of practitioners, found a 2% difference in intubation success (P = 0.12) between physicians and nonphysicians (Table 1), which was not statistically significant. Rapid sequence induction was left out of the final model, because all physicians utilised this induction and its inclusion would needlessly inflate variance.