Introduction: Traditionally, paramedic students have completed human advanced airway placements in operating rooms, emergency departments (EDs), or other similar venues during their field internships. Anecdotally, paramedic programs report less frequent endotracheal intubations (ETIs) in the operating room (OR) and ED. This study hypothesizes that the number of advanced airway placements per student has decreased since 2001. This study examined the frequency of placement, type of airway, and educational settings where advanced airway management occurred from 2001 to 2009 in a variety of settings across the United States. Methods: A retrospective review of prospectively reported airway procedures documented by paramedic students in FISDAP, a national database of prospectively reported internship experiences, was completed. Inclusion criteria were as follows: 1) student graduated from program; 2) data were verified by preceptor; 3) student provided consent; and 4) minimum of one airway placement recorded. Students whose number of endotracheal tube (ET) placements was 2 standard deviations from the mean were excluded as outliers. Results: In all, 6,571 records from 2001 to 2009 were reviewed,with 1,376 excluded based on a priori criteria, leaving 5,195 records for analysis. In each year, the median number of airway devices placed per student was greatest in the hospital setting. ETI was uniformly more common than alternate airways. The median number of field ETIs per student ranged from 0 to 1, with a median alternate-device rate of 0 for both settings. The median number of hospital ETIs per student remained constant at 7 (Fig. 1). Conclusion: Paramedic students place more advanced airways in the hospital than in the field. ETI remains more common than alternate airways. The median number of ETIs per paramedic student has remained constant at 7 from 2003 to 2009.