Reconsidering Prehospital Endotracheal Intubation as a Common Medical Intervention for Patients Presenting with Respiratory Distress
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Intubation is the use of an endotracheal tube on a patient and is performed in a variety of settings. Intubation is used in the field when a paramedic faces a trauma victim of a car crash or a patient experiencing a medical respiratory problem. Anesthesiologists often have to intubate a patient before surgery and nurses often intubate patients that have been in their care for a while, when suddenly the patient's condition deteriorates. An endotracheal tube has developed into a crucial tool in the management of a patient's airway. It is vital to have an open airway to allow the proper function of the ABCs. An endotracheal tube has become an accepted part of emergency respiratory care so much so that it is assumed that its use is always in the best interest of the patient, when, as growing evidence has proved it is not always the case. Though endotracheal intubation can be a powerful respiratory maneuver to sway a deadly patient situation back to a stable condition a recent overwhelming surge of medical journal articles has caused the health community to lose confidence in the application of endotracheal tubes. Patients with severe head trauma that underwent endotracheal intubation outside of the hospital experienced, compared to those intubated in the hospital, had a mortality rate four times the in-hospital intubated group. Intubation is a procedure performed in a great variety of settings, seemingly lacking a forceful imposing force to distinguish its necessity in these different settings. When one looks at the extreme discrepancy in the outcomes and complications of intubation performed in these different settings, one realizes more discerning guidelines are needed to enforce proper use of the endotracheal tube.