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Institution: University of Pittsburgh
Grant Title: Effect
of Out-of-Hospital Endotracheal Intubation Errors
Grant Number: K08 HS013628
Total Award: $629,910
Project Description: The purpose of this project was to identify the patterns and effects of errors occurring in out-of-hospital endotracheal intubation (OOH-ETI) performed by paramedics. In phase I of the study, the PI examined whether variations in EMS system structure, population setting, socioeconomic status, or patient racial and ethnic background are associated with the incidence of OOH-ETI errors. In the second phase, he investigated whether OOH-ETI errors affect patient outcomes or in-hospital resource utilization.
Career Goals: Dr. Wang is an Associate Professor of Emergency Medicine and Vice Chair for Research at the University of Alabama Hospital in Birmingham. He received his MD from UMDNJ Robert Wood Johnson Medical School followed by a residency in Emergency Medicine in the Christiana Care Health System in Newark, Delaware. Dr. Wang was then a Research Fellow in the Department of Emergency Medicine at the University of Pittsburgh.
Progress to Date: This grant has been completed. An ETI error occurred in 22.7% of patients, including tube misplacement/dislodgement in 31.%, multiple ETI attempts in 3.2%, and failed ETI in 18.5%. Out-of-hospital ETI errors were not associated with early or later death. However, failed ETI was associated with pneumonitis.
Future Plans: Dr. Wang will continue his health services research career and has successfully obtained other Federal funding for his work.
Highlights and Specific Accomplishments:
Investigator Award, Society for Academic Emergency Medicine, May 2005.
- Peer Reviewer for several journals.
K-Generated Publications (selected):
Wang HE, Peitzman AB, Cassidy L, Adelson PD, Yealy DM:
Out-of-hospital endotracheal intubation and outcome after traumatic brain injury.
Annals of Emergency Medicine 2004. 44(5):439-50.
Wang HE, Seitz SR, Hostler DP: Defining the "learning
curve" for paramedic student endotracheal intubation. Prehospital Emergency Care 2005. 9:156-62
Wang HE, Kupas DF, Greenwood MJ, Pinchalk ME, et al. An algorithmic
approach to prehospital airway management. Prehospital Emergency Care 2005. 9:156-62.
Wang HE, Callaway CW, Peitzman AB, Tisherman SA. Admission hypothermia
and outcome after major trauma. Critical Care Medicine 2005. 6:1296-1301.
Guyette FX, Wang HE,
Cole JS. King airway use by air medical providers. Prehospital Emergency Care
Wang HE, Abo BM, Lave JR, Yealy DM. How would minimum
experience standards impact the distribution of out-of-hospital endotracheal
intubations? Annals of Emergency Medicine 2007. 40:246-52.
Wang, HE, Shapiro NI, Angus DC, Yealy DM. National estimates
of severe sepsis in United States emergency departments. Critical Care Medicine 2007. 35:1928-36.
Whyte AJ, Wang HE.
Prehospital airway management complicated by reported pseudocholinesterase
deficiency. Prehospital Emergency Care 2007. 44:343-45.
Cudnik MT, Newgard DC, Wang
HE, et al. Endotracheal intubation increases out-of-hospital time in trauma
patients. Prehospital Emergency Care 2007.11:224-29.
Thomas JB, Abo BN, Wang HE.
Paramedic perceptions of challenges in out-of-hospital endotracheal intubation.
Prehospital Emergency Care 2007. 11:219-23.
Abo, BN, Hostler DP, Wang
HE. Does the type of out-of-hospital airway interfere with other
cardiopulmonary resuscitation tasks? Resuscitation 2007. 72:234-39.
Wang HE, Fairbanks RJ, Shah MN, et al. Tort claims from adverse events in EMS. Annals of Emergency Medicine 2008. 52(3):256-62.
Wong ML, Carey S, Mader TJ, Wang HE. Effect of device features on ability of untrained layperson to use AEDS. Resuscitation 2009. 80(111):1285-89.
Wang HE, Simeone A, Callaway CW. Interruptions in cardiopulmonary resuscitation from paramedic endotracheal intubation. Annals of Emergency Medicine 2009. 54:545-52.
Wang HE, Cook L, Change CC, et al. Outcomes after out-of-hospital endotracheal intubation errors. Resuscitation 2009. 80:50-55.
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