根據2005年8月期《重癥監護醫學》的一項研究報道，急診醫學研究人員發現，在患者被送到醫院的時候，許多護理人員不具備足夠的急診氣管插管的臨床經驗。

氣管內插管（ETI）是一種急診醫療程序，用于向患者肺內輸送氧氣。使用過去一年的患者資料，美國匹茲堡大學醫學院的研究人員分析檢查了護理人員操作的插管頻率。他們發現三分之二的護理人員每年操作的插管次數少于3次，而且總計40％的護理人員根本沒有操作過。盡管該項研究顯示空中醫療人員和城市護理人員操作氣管的機會多一些，但是這些差異非常之小。

在美國的護理學生通常被要求在畢業之前完成5次插管手術，與急診科住院醫生相比，他們被要求35次操作，或者麻醉科住院醫生則在畢業之前必須完成50次操作。以前對綜合醫療手術的研究表明，錯誤發生率、不良事件、預后很差都與手術經驗的多少有關系。

美國匹茲堡大學醫學院急診醫學助理教授、該篇論文的主要作者Henry E. Wang說“我們需要找到更好的辦法，對護理人員操作這種困難手術的能力進行培訓，或者找到更好更簡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.