Prehospital Intubation Saves Lives and Costs

Respiratory therapists who work on transport teams know how vital prehospital care is to trauma patients. A recent study out of the U.K. finds that one aspect of that care that may not be available to all trauma patients can significantly increase survival.

The investigators used an AI model to examine the effect of prehospital emergency intubation on 30-day survival among 6,467 trauma patients treated at a single trauma center. To isolate the impact of intubation from other factors that could influence outcomes, the study examined who would need intubation and who would most likely survive.  

The trauma patients included in the study came from a mixed rural-urban U.K. setting in which physician-paramedic teams performed all prehospital intubations.

A new machine learning tool, “Intub-8,” was used to predict outcomes based on eight routinely collected prehospital measures.

Results showed:

• Among 229 high-risk patients identified by the model as needing intubation, those who received it before arriving at the hospital were 10.3% more likely to survive within 30 days than those who did not.
• When the findings were scaled up relative to national trauma incidence, the researchers estimated that if every trauma patient who needed prehospital intubation received it, 170 lives could be saved each year in the U.K. 
• A cost-effectiveness analysis revealed that cost savings would be in the range of 101 million English pounds annually for the U.K., due to reduced costs of further care and lives saved.

The authors credit their ability to assess the value of prehospital intubation in this study to their use of AI to analyze the data.

“Until now, advanced air ambulance services across the world who respond to critically injured patients have struggled to conduct studies that assess the benefit and cost effectiveness of their life-saving interventions,” said study author Julian Thompson, clinical director of the Severn Major Trauma Network. “The use of AI in this study has allowed us to analyze existing data in a totally new way. This reveals the huge impact that advanced care provides when delivered before arrival in hospital.”

The authors believe if their analysis is proven to be generalizable to other critical care transport programs around the world, it could be used to identify patients most likely to benefit from prehospital intubation and direct appropriately trained transport teams to those patients.

“We argue that increased provisioning for prehospital intubation, including dedicated emergency medical staff training and central funding of specialist critical care teams with prehospital emergency anesthesia capability, can now be motivated on health care economic grounds, and should be stimulated with urgency,” they wrote.

The study was published by The Lancet Respiratory Medicine. 

Highlighted in RC Buzz March 2, 2026