| Emergency airway management: a multi-center report of 8937 emergency department intubations. | |
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MedLine Citation:
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PMID: 20434289 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objective: Emergency department (ED) intubation personnel and practices have changed dramatically in recent decades, but have been described only in single-center studies. We sought to better describe ED intubations by using a multi-center registry. Methods: We established a multi-center registry and initiated surveillance of a longitudinal, prospective convenience sample of intubations at 31 EDs. Clinicians filled out a data form after each intubation. Our main outcome measures were descriptive. We characterized indications, methods, medications, success rates, intubator characteristics, and associated event rates. We report proportions with 95% confidence intervals and chi-squared testing; p-values < 0.05 were considered significant. Results: There were 8937 encounters recorded from September 1997 to June 2002. The intubation was performed for medical emergencies in 5951 encounters (67%) and for trauma in 2337 (26%); 649 (7%) did not have a recorded mechanism or indication. Rapid sequence intubation was the initial method chosen in 6138 of 8937 intubations (69%) and in 84% of encounters that involved any intubation medication. The first method chosen was successful in 95%, and intubation was ultimately successful in 99%. Emergency physicians performed 87% of intubations and anesthesiologists 3%. Several other specialties comprised the remaining 10%. One or more associated events were reported in 779 (9%) encounters, with an average of 12 per 100 encounters. No medication errors were reported in 6138 rapid sequence intubations. Surgical airways were performed in 0.84% of all cases and 1.7% of trauma cases. Conclusion: Emergency physicians perform the vast majority of ED intubations. ED intubation is performed more commonly for medical than traumatic indications. Rapid sequence intubation is the most common method of ED intubation. |
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Authors:
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Ron M Walls; Calvin A Brown; Aaron E Bair; Daniel J Pallin; |
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Publication Detail:
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Type: Journal Article Date: 2010-11-09 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: 41 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 347-54 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Division of Emergency Medicine, Harvard Medical School, Boston, Massachusetts. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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