| Airway management in the emergency department: a one-year study of 610 tracheal intubations. | |
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MedLine Citation:
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PMID: 9506489 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: To describe the methods, success rates, and immediate complications of tracheal intubations performed in the emergency department of an urban teaching hospital. METHODS: This was an observational, consecutive series undertaken in an urban university hospital with an emergency medicine residency training program and an annual ED census of 60,000 patients. The study population included all patients for whom intubation was attempted in the ED during a 1-year period (July 1, 1995 through June 30, 1996). At the time of each intubation, the intubator filled out an intubation data collection form. If an intubation was performed in the ED but no form was filled out, the data were obtained from the medical record. RESULTS: A total of 610 patients required airway control in the ED; 569 (93%) were intubated by emergency medicine residents or attending physicians. Rapid-sequence intubation (RSI) was used in 515 (84%). A total of 603 patients (98.9%) were successfully intubated; 7 patients could not be intubated and underwent cricothyrotomy. In 33 patients, inadvertent placement into the esophagus occurred; all such situations were rapidly recognized and corrected. Eight (24%) of the 33 esophageal intubations resulted in a reported immediate complication. Overall, 49 patients (8.0%; 95% confidence interval [CI], 6% to 11%) experienced a total of 57 immediate complications (9.3%; 95% CI, 7% to 12%). Three patients sustained a cardiac arrest after intubation; two of these patients had agonal rhythms before intubation, and one probably had a succinylcholine-induced hyperkalemic cardiac arrest. CONCLUSION: At this institution, the majority of ED intubations were performed by emergency physicians and RSI was the most common method used. Emergency physicians intubated critically ill and injured ED patients with a very high success rate and a low rate of serious complications. |
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Authors:
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J C Sakles; E G Laurin; A A Rantapaa; E A Panacek |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of emergency medicine Volume: 31 ISSN: 0196-0644 ISO Abbreviation: Ann Emerg Med Publication Date: 1998 Mar |
Date Detail:
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Created Date: 1998-04-06 Completed Date: 1998-04-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8002646 Medline TA: Ann Emerg Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 325-32 Citation Subset: AIM; IM |
Affiliation:
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Division of Emergency Medicine, University of California, Davis, Medical Center, School of Medicine Sacramento, 95817, USA. jcsakles@ucdavis.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over California Child Child, Preschool Emergency Service, Hospital / standards* Hospitals, Teaching Humans Infant Infant, Newborn Intubation, Intratracheal* / adverse effects, methods Medical Staff, Hospital Middle Aged Neuromuscular Depolarizing Agents Prospective Studies Succinylcholine |
| Chemical | |
Reg. No./Substance:
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0/Neuromuscular Depolarizing Agents; 306-40-1/Succinylcholine |
| Comments/Corrections | |
Comment In:
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Ann Emerg Med. 1998 Mar;31(3):398-400
[PMID:
9506500
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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