In this episode of the FlightBridgeED Podcast, Dr. Mike Lauria welcomes back Dr. Nick George to dissect a topic that’s long overdue for critical discussion: airway management in critical care transport—and whether your background matters.
Does being a paramedic or a nurse predict first-pass success rate? Does prior training or clinical experience truly change how well you manage airways in high-stakes situations?
Drawing from new research involving over 7,800 intubations at a major HEMS program, Dr. George presents data that challenges long-held assumptions and explores the impact of training, experience, and clinical culture on airway outcomes. From the historical roots of EMS to the realities of modern-day prehospital practice, this episode bridges the past, present, and future of one of the most defining and debated skills in critical care.
Whether you're placing tubes daily or just entering the field, this episode delivers real insights for every provider level.
Listen anywhere you stream podcasts, or at FlightBridgeED.com. While you're there, explore our award-winning, trusted courses, specifically designed for critical care professionals like you.
Key Takeaways
- Success in airway management isn't about your credentials—it’s about training, experience, and repetition.
- In a study of 7,812 intubations, there was no statistically significant difference in first-pass or last-pass success between nurses and paramedics.
- A slight initial gap in first-year performance disappears by year three, suggesting a washout effect driven by experience, not title.
- Historical models and current cultures (like “owning the airway”) influence skill allocation, sometimes more than evidence.
- Airway success is more than just getting the tube—metrics like DASH-1A aim to measure outcomes that matter (hypoxia, hypotension), even if imperfect.
- High-quality, consistent training programs—like annual OR intubations and in-situ simulation—are the real equalizers in skill development.
- The origin of airway obsession in EMS traces back to Peter Safar, whose daughter’s death from an asthma attack helped spark the creation of modern paramedicine.
References
George, Nicholas H et al. “Prehospital Endotracheal Intubation Success Rates for Critical Care Nurses Versus Paramedics.” Prehospital emergency care, 1-7. 23 Jan. 2025, doi:10.1080/10903127.2024.2448246
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!