根據(jù)2005年8月期《重癥監(jiān)護(hù)醫(yī)學(xué)》的一項(xiàng)研究報(bào)道，急診醫(yī)學(xué)研究人員發(fā)現(xiàn)，在患者被送到醫(yī)院的時(shí)候，許多護(hù)理人員不具備足夠的急診氣管插管的臨床經(jīng)驗(yàn)。

氣管內(nèi)插管（ETI）是一種急診醫(yī)療程序，用于向患者肺內(nèi)輸送氧氣。使用過去一年的患者資料，美國(guó)匹茲堡大學(xué)醫(yī)學(xué)院的研究人員分析檢查了護(hù)理人員操作的插管頻率。他們發(fā)現(xiàn)三分之二的護(hù)理人員每年操作的插管次數(shù)少于3次，而且總計(jì)40％的護(hù)理人員根本沒有操作過。盡管該項(xiàng)研究顯示空中醫(yī)療人員和城市護(hù)理人員操作氣管的機(jī)會(huì)多一些，但是這些差異非常之小。

在美國(guó)的護(hù)理學(xué)生通常被要求在畢業(yè)之前完成5次插管手術(shù)，與急診科住院醫(yī)生相比，他們被要求35次操作，或者麻醉科住院醫(yī)生則在畢業(yè)之前必須完成50次操作。以前對(duì)綜合醫(yī)療手術(shù)的研究表明，錯(cuò)誤發(fā)生率、不良事件、預(yù)后很差都與手術(shù)經(jīng)驗(yàn)的多少有關(guān)系。

美國(guó)匹茲堡大學(xué)醫(yī)學(xué)院急診醫(yī)學(xué)助理教授、該篇論文的主要作者Henry E. Wang說“我們需要找到更好的辦法，對(duì)護(hù)理人員操作這種困難手術(shù)的能力進(jìn)行培訓(xùn)，或者找到更好更簡(jiǎn)單的方法來處理氣道。”
 
Paramedic-Training Challenges
 
Emergency medical researchers have found that many paramedics do not have enough clinical experience in the insertion of emergency breathing tubes in patients before arriving at a hospital, according to a study in the August 2005 issue of Critical Care Medicine.

Endotrachial intubation (ETI) is an emergency medical procedure performed to deliver oxygen into a patient’s lungs. Using patient data over one year, researchers at the University of Pittsburgh School of Medicine (PA, USA) examined the frequency of intubation performed by paramedics. They found that two-thirds of paramedics performed intubation less than three times per year while 40% performed no intubations at all. Although the study showed that air medical and urban paramedics were exposed to slightly more intubation procedures, these differences were small.

Paramedic students in the United States are required to perform only five intubation procedures before graduation, compared to emergency medicine residents, who are required to perform 35, or anesthesiology residents, who must complete 50 before graduation. Prior studies of complex medical procedures have shown that the occurrence of errors, adverse events, and poor outcomes is associated with the volume of procedural experience.

“We need to find better ways to train paramedics to perform this very difficult procedure or find better and simpler ways to manage the airway,” said lead author Henry E. Wang, M.D., M.P.H., assistant professor of emergency medicine at the University of Pittsburgh School of Medicine.