Document Detail


Populations at risk for intubation nonattempt and failure in the prehospital setting.
MedLine Citation:
PMID:  16036840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pediatric cardiac arrest patients and adult traumatic arrest patients are perceived as more difficult to endotracheally intubate than adult cardiac arrest patients. The study hypothesis was that these populations were at higher risk of endotracheal intubation failure compared with adult cardiac arrest patients and that paramedics would more frequently defer attempts to intubate these patients. METHODS: This was a retrospective, observational study analyzing oral endotracheal intubations on pediatric cardiac arrest, adult traumatic arrest, and adult cardiac arrest patients over 66 months. Homogeneity of intubation nonattempt and endotracheal intubation failure was studied with chi-square analysis. Relative risks (RRs) with 95% confidence intervals (CIs) were used to compare pediatric cardiac arrest with adult traumatic arrest with adult cardiac arrest nonattempt rates and endotracheal intubation failure rates. RESULTS: 2,669 oral endotracheal intubations were included. There was a significant difference in intubation nonattempts and intubation failure between the combined pediatric cardiac arrest and adult traumatic arrest groups and the adult cardiac arrest cohort (RR 7.24, 95% CI 5.73, 9.16 for nonattempt; RR = 2.33, 95% CI 1.93, 2.83 for intubation failure). Both groups individually showed significant risk for intubation nonattempt and endotracheal intubation failure compared with adult cardiac arrest, with the pediatric cohort at higher risk for failure and the adult traumatic arrest cohort at higher risk for nonattempt. CONCLUSIONS: There was significant risk of intubation nonattempt and intubation failure in the pediatric cardiac arrest and adult traumatic arrest cohorts compared with the adult cardiac arrest population, with the pediatric cohort being at particularly high risk for intubation failure and the adult traumatic arrest cohort at higher risk for nonattempt.
Authors:
Alex G Garza; D Adam Algren; Matthew C Gratton; O John Ma
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  9     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2005 Apr-Jun
Date Detail:
Created Date:  2005-07-22     Completed Date:  2005-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-6     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA. alex.garza@tmcmed.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Child
Emergency Medical Services / statistics & numerical data*
Heart Arrest / etiology,  therapy
Humans
Intubation, Intratracheal / statistics & numerical data*
Missouri
Retrospective Studies
Risk Factors
Treatment Failure
Wounds and Injuries / complications,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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