Evaluation of endotracheal intubations in the emergency department of a tertiary care facility
Mustafa Koray Yildirim1, Erkan Göksu2, Mohamad El Warea3
1Emergency Service, Sorgun State Hospital, Yozgat, Turkey
2Department of Emergency Medicine, Akdeniz University School of Medicine, Antalya, Turkey
3Department of Emergency Medicine, Aman Hospital, Doha, Qatar
Keywords: Airway management, emergency medicine, endotracheal intubation
OBJECTIVE: In this study, we aimed to evaluate the performance of emergency department intubations for 1 year.
METHODS: This was a retrospective analysis of prospectively collected data. The collected variables were patient demographics, indication for intubation, preintubation hemodynamics, preoxygenation methods, medications used for premedication, induction and paralysis, type of laryngoscope used, Cormack Lehane (C L) grades, number of intubation attempts, and peri intubation adverse events.
RESULTS: A total of 194 patients were included. The median age of the population was 66.5 years (53.75–79); 61.9% of the patients were male. The majority of the patients were intubated due to medical conditions. The main indication for endotracheal intubation was respiratory failure in 38.6% of the patients. Preoxygenation before intubation was performed in 87.2% of the patients. Fifty eight percent of the population were hemodynamically stable before the intubation. Fentanyl was the agent used for premedication, induction agents of choice were ketamine and midazolam, and rocuronium was the neuromuscular blocking agent. The C L grades 1 and 2 were detected in 87.6% of the patients. The first pass success rate was 72.8%. The peri intubation adverse events were mainly hypotension and desaturation observed in 82 (42%) patients. The patients with higher C L grades needed more intubation attempts (P < 0.001). Peri intubation adverse events were associated with the increased number of intubation attempts (P < 0.001).
CONCLUSION: This and similar studies or an airway registry on a national level may help improve the quality of service given and delineate the deficiencies of the airway related procedures in the emergency department.
How to cite this article: Yildirim MK, Göksu E, El Warea M. Evaluation of endotracheal intubations in the emergency department of a tertiary care facility. Turk J Emerg Med 2023;23:82-7.
This study was approved by the Akdeniz University Clinical Research Ethics Committee and obtained data usage permission (10.02.2021– KAEK‑107).
Board name: Akdeniz University Faculty of Medicine Clinical Research Ethics Committee.
Ethics committee code: 2012‑ KAEK‑ 20.
Concept – M.K.Y., E.G., M.E.W.; Design – M.K.Y., E.G., M.E.W.; Supervision–E.G.; Resources –M.K.Y., E.G., M.E.W.; Materials –M.K.Y., E.G.; Data Collection and/or Processing ‑ M.K.Y., E.G.; Analysis and/or Interpretation – M.K.Y., E.G.; Literature Search ‑ M.K.Y., E.G.; Writing Manuscript ‑ M.K.Y., E.G., M.E.W.; Critical Review ‑ M.K.Y., E.G.