Paramedic RSI in patients with non-traumatic coma has a high procedural success rate. Further studies are required to determine whether this procedure improves outcomes.

Objective: To quantify the potential time saved with pre-hospital antibiotic therapy in sepsis. Methods: Study data for adult patients transported by Ambulance Victoria (AV), and enrolled into the Australasian Resuscitation In Sepsis Evaluation (ARISE), were linked with pre-hospital electronic records. Results: An AV record was identified for 240 of 341 ARISE patients. The pre-hospital case notes referred to potential infection in 165 patients. The median time to first antibiotic administration from loading the patient into the ambulance was 107 (74-160) min. Conclusions: ARISE patients in Victoria were frequently identified prehospital. An opportunity exists to study the feasibility of pre-hospital antibiotic therapy. Maximum 15 (15-15) Minimum 15 (14-15) Proportion GCS <15, n (%) (n = 239) 88 (36.8) RR, median (IQR) (per min) (n = 239) Initial 24 (18-36) Maximum 24 (18-36) Minimum 20 (18-28) Heart rate, median (IQR) (per min) (n = 237) Initial 113 (99-130) Maximum 113 (99-130) Minimum 108 (92-120) SBP, median (IQR) (mmHg) (n = 237) Initial 90 (80-120) Maximum 110 (90-130) Minimum 90 (75-110) Any pre-hospital i.v. fluid, n (%) (n = 239) 88 (36.8) Volume pre-hospital i.v. fluid, median (IQR) (mL) (n = 88) 1000 (500-1425) Screening ‡ lactate, median (IQR) (mmol/L) (n = 89) 5.8 (4.6-7.5) Screening ‡ MAP, median (IQR) (mmHg) (n = 111) 58 (52-62) Screening ‡ SBP, median (IQR) (mmHg) (n = 161) 80 (75-85)

ObjectivesEmergency intubation in children is an infrequent procedure both in the pre‐hospital and hospital setting. The anatomical, physiological and situational challenges together with limited clinician exposure can make this a difficult procedure with high risk of adverse events. The aim of this collaborative study between a state‐wide ambulance service and a tertiary children's hospital was to describe the characteristics of pre‐hospital paediatric intubations by Intensive Care Paramedics.MethodsWe conducted a retrospective review of state‐wide ambulance service electronic patient care records (ePCRs) in Victoria, Australia, population: 6.5 million. Children aged 0–18 years who were attended by paramedics over a 12‐month period that required advanced airway management were analysed for demographics and first‐pass success rate.ResultsParamedics attended 2674 cases aged 0–18 years over the 12‐month study period who received basic or advanced airway management. A total of 78 cases required advanced airway management. The median age of patients was 12 years (interquartile range 3–16) and most were male (60.2%). Sixty‐eight patients (87.5%) were intubated successfully on the first attempt, first‐pass success was lowest in children <1 year of age. The most common indications for pre‐hospital intubation were closed head injury and cardiac arrest. It was not possible to report complication rates because of incomplete documentation.ConclusionPre‐hospital intubation in children is performed infrequently in an extremely unwell patient group. Continued high‐level paramedic training is required to prevent adverse events and ensure patient safety.