The following is a summary of “Association Between Emergency Medical Service Agency Intubation Rate and Intubation Success,” published in the January 2024 issue of Emergency Medicine by Thomas et al.

The association between the rate of overall agency intubation attempts and intubation success in out-of-hospital care remains unclear.

Researchers conducted a retrospective study to evaluate the association between agency intubation attempt rate and intubation success using a national out-of-hospital database.

They evaluated the ESO Data Collaborative, which spans 2018 to 2019. It included all adult cases with attempted endotracheal intubation, calculating the rate of intubations per 100 responses, advanced life support responses, & transports for each agency. Excluding cases from healthcare facilities and outliers, they employed multivariable logistic regression, adjusting for confounders, to assess the relationship between agency intubation attempt rate and overall intubation and first-pass success.

The result showed data from 1,005 agencies, with 58,509 intubation attempts. The overall intubation success rate was 78.8%, with a first-pass success rate of 68.5%. The median rate of intubation attempts per 100 emergency medical service responses per agency was 0.8 (IQR 0.6 to 1.1). Intubation attempts per 100 responses (adjusted odds ratio [aOR] 1.7; 95% CI 1.6 to 1.8), advanced life support responses (aOR 1.18; 95% CI 1.16 to 1.20), and transports (aOR 1.21; 95% CI 1.18 to 1.22) were all associated with intubation success. Similar associations were observed for first-pass success, albeit with smaller effect sizes.

Investigators concluded that increased agency rates of intubation attempts were associated with higher rates of intubation and first-pass success.

Source: annemergmed.com/article/S0196-0644(23)01353-7/fulltext#%20