Which of the following statement(s) is/are true concerning endotracheal intubation at the site of injury?

b. Paramedic intubation in the field is successful in over 90% of cases

c. Indications for intubation in the field include respiratory distress, significant head injury, severe chest injury and hypovolemic shock

The most immediately life-threatening problem to the injured patient is loss of airway patency and therefore this is the first priority of the first response team upon arrival at the injury site. Basic life support skills such as suctioning, placement of oropharyngeal airways, the use of a bag mask device are usually sufficient at least to temporarily restore oxygenation at the injury site. On the other hand, approximately 10% of patients require endotracheal intubation and up to 20% would benefit from field intubation. Endotracheal intubation is the best procedure for airway control in patients who are in shock, have abnormal breathing patterns, or who are unable to protect their airways due to unconsciousness. Endotracheal intubation is far superior than that of bag valve mask systems because it provides larger total volumes and less risk of aspiration.

Indications for endotracheal intubation in the field should include respiratory distress, hypovolemic shock, unconsciousness, significant head injury, and severe chest injury. Reported paramedic intubation success rates range between 90 and 98% in the literature, and complications are rare. On the other hand, there are problems with intubation at pre-hospital sites. Patients with head injuries may have C-spine injuries so in-line mobilization techniques are necessary to insure intubation without further injury to the cervical spine or cord. Patients often clench their teeth in which case either nasotracheal intubation or the use of paralytic agents such as succinylcholine may be necessary for successful intubation.