Very few patients intubated without drugs survive

Intubating patients without the use of muscle relaxants or anaesthetics drugs, as is the practice of UK paramedics, results in very poor survival rates according to a retrospective database study by Lockey and colleagues (p 141). They found that out of 486 patients with trauma who were intubated without drugs (55.8% by physicians and 43.9% by paramedics), only one survived. Laryngoscopy and attemped intubation without drugs have potential risks such as increasing intracranial pressure, vomiting, and unrecognised oesophageal intubation. The authors suggest that since there have been no controlled trials of different methods of airway management, the use of non-drug assisted intubation deserves further scrutiny.

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Relevant Article

Survival of trauma patients who have prehospital tracheal intubation without anaesthesia or muscle relaxants: observational study

David Lockey, Gareth Davies, and Tim Coats
BMJ 2001 323: 141. [Full Text] [PDF]