Intubation of Children Questioned by Study

A three-year study of 830 gravely injured children in Los Angeles and Orange counties is challenging the conventional wisdom on a life-or-death issue.

It found that inserting a tube directly into the airway of a child whose breathing had slowed or stopped is no better than manually forcing air into the lungs by squeezing a bag attached to an oxygen mask.

Emergency personnel have been trained to intubate children as a matter of routine. The study, to be published today in the Journal of the American Medical Assn., has already changed rescue practices in Los Angeles County and Orange County, health officials said.

The study, said to be the largest of its kind, was led by Dr. Marianne Gausche, an emergency medicine specialist at the Harbor-UCLA Medical Center in Torrance.

“It’s better if paramedics use the safe and simple method of bag-valve-mask ventilation while rushing the child to the hospital than if they try the relatively risky process of intubation,” she said.

The researchers compared 410 injured children who were resuscitated with the bag-and-mask method to 430 who underwent intubation from 1994 to 1997.