A multi-faceted advanced airway management (AAM) quality improvement program (QIP) resulted in statistically significant increase in intubation first pass success rates (FPS) rates and a non-significant improvement in DASH-1A rates.

A combination of modern equipment, targeted training, standardization, and ongoing clinical governance is required to achieve and maintain safe intubation by paramedics in the prehospital and retrieval environment.

This before and after study cannot clearly prove cause and effect of the AAM QIP and improved intubation FPS rates. However, the effect size is considerable and in keeping with previous literature.

An important limitation is that the multiple aspects of the QIP were introduced in parallel, and due to the relative infrequence of intubations in our service, there is a likely delay between intervention and effect.

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