OMDs issue statement on intubation by Intermediate providers

The regional Operational Medical Directors recently issued a position on the practice of endotracheal intubation by Intermediate level providers in the Central Shenandoah EMS Council region.

In 2009, the regional Performance Improvement Committee (PIC) began collecting and reviewing data on advanced airway management, including endotracheal intubation. The review of provider performance has been enlightening and has led to improved practice standards. A major practice modification was the introduction of the endotracheal tube introducer, commonly known as the bougie, which improved first attempt success rates by upwards of 20 points. Other initiatives that sought to improve performance included training administered through annual updates and recommendations for frequent agency-level skill practice.

While moderate performance improvement has been realized, disparity continues to exist, particularly based on certification level. In 2016, Intermediate level providers continued to trail behind industry benchmarks for intubation success, while Paramedic level providers met benchmarks. The PIC has also been reviewing advanced airway management using video-laryngoscopy. Early indicators suggest that improved performance may be achieved using this device.

Dr. Asher Brand, Regional Medical Director, has released a memorandum on behalf of all regional Operational Medical Directors, outlining the position of the medical directors, including additional clinical guidance. The full memorandum can be downloaded below.

Memo (2017-01-26): Video Laryngoscopy by Intermediate Providers (0.3 MiB, 820 downloads)