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If you are successful as an agency at intubating, why would you get rid of ETTs. While this study shows better outcomes with the LTs, i dont think its because of the physical plastic tube. My takeaway from this is that people who have low exposure and opportunity to intubate stink at it, and that delay of a an airway is what causes the poorer outcomes.
I think it's quite clear that a big part of the reason that the research is so unsupportive of prehospital intubation is the fact that most paramedics just aren't very good at it because they don't do it very often. But there's more to it than that, as this study indicates.
As far as my agency goes, "Expected clinical course" is a big point of emphasis for our MD and the hospitals. They very much emphasis that if we think this patient is going to get intubated in the hospital, then knock them down in the field.
Even if one were to assume that prehospital intubation is beneficial as opposed to the alternatives (a claim which has never been proven despite many attempts), how could one possibly think that just because a patient might have a critical procedure performed in the hospital later on, that they are automatically better off having that critical procedure done in a setting with much less expertise and resources?