The Resus Room February 2026; papers of the month
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Feb 1, 2026 They debate whether intubating inside an ambulance is safe and sometimes faster than moving patients out. They explore defibrillator pad placement and its surprising effect on return of spontaneous circulation. They examine a large trial comparing ketamine versus etomidate for induction and the implications for peri‑intubation cardiovascular collapse.
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Ambulance Intubation Is Not Necessarily Riskier
- Intubating selected patients inside an ambulance did not increase major complication rates compared with intubation on a stretcher outside the vehicle.
- Doing so reduced total scene time by about four minutes in this single-centre prehospital cohort.
Ground Intubations Reflect Sicker Patients
- Ground intubations had higher complication rates but were performed in patients who were more physiologically unstable at baseline.
- High first-pass success across locations suggests operator skill and selection bias explain much of the outcome differences.
Practice Ambulance Airway Work In Simulation
- Run simulation and familiarisation for intubation inside local ambulance types before changing practice.
- Use local audit and governance to confirm transferability rather than assuming single-centre results generalise.