Survey of Out-of-hospital Emergency Intubations in the French Prehospital Medical System: A Multicenter Study (original) (raw)

Difficult and failed intubation in the first 4000 incidents reported on webAIRS

Anaesthesia and Intensive Care, 2020

A review of the first 4000 reports to the webAIRS anaesthesia incident reporting database was performed to analyse cases reported as difficult or failed intubation. Patient, task, caregiver and system factors were evaluated. Among the 4000 reports, there were 170 incidents of difficult or failed intubation. Difficult or failed intubation incidents were most common in the 40–59 years age group. More than half of cases were not predicted. A total of 40% involved patients with a body mass index >30 kg/m2 and 41% involved emergency cases. A third of the reports described multiple intubation attempts. Of the reports, 18% mentioned equipment problems including endotracheal tube cuff rupture, laryngoscope light failure, dysfunctional capnography and delays with availability of additional equipment to assist with intubation. Immediate outcomes included 40 cases of oxygen desaturation below 85%; of these cases, four required cardiopulmonary resuscitation. The majority of the incidents res...

Emergency Airway Management: A Multi-Center Report of 8937 Emergency Department Intubations

The Journal of Emergency Medicine, 2011

e Abstract-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 multicenter 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

Evaluation of Various Factors Affecting Emergency Intubation

Academia Anesthesiologica International, 2019

Background: Inadequate airway management is a major contributor to pre-hospital morbidity and mortality. The present study was conducted to evaluate various factors affecting endotracheal intubation. Subjects and Methods: This study was conducted on 474 patients requiring ETI. Informed consent was obtained from family members of all patients. Emergency intubation was performed as a 'rapid sequence induction' (RSI), with preoxygenation and cricoid pressure followed by an induction agent and then suxamethonium. Factors affecting ETI was recorded. Results: Out of 476 patients, males were 280 and females were 196. Indication of RTI was low GCS seen in 64, injury in 320, respiratory insufficiency in 10 and cardiac arrest in 82. The difference was significant (P< 0.05). Method of ETI was RSI in 290, without relaxant in 81 and without any medication in 105. The difference was significant (P-0.05). Common difficulties in ETI were blood seen in 30%, vomit in 14%, hypersalivation in 28%, anatomical difficulties in 7%, patient position in 10% and technical problems in 11%. The difference was significant (P<0.05). Conclusion: The presence of blood, vomit, hypersalivation, anatomical difficulties, patient position and technical problems are among various factors affecting ETI.

Intubation in emergency department of a tertiary care hospital in a low-income country

Journal of the Pakistan Medical Association, 2013

Objective: To study the indications, method, success rate and complications of intubation at the Emergency Department of a private, tertiary care hospital in Karachi, Pakistan. Methods: The case series involved 278 patients above 14 years of age who underwent emergency intubation at the Emergency Department of Aga Khan University Hospital, Karachi between 1998 and 2003. Descriptive statistics were used to compare rapid sequence intubation with crash intubation. The level of significance was p<0.05. Results: Of the total 278 intubations performed, 37 (13.3%) had to be left out for incomplete information. The study population remaining for inferential analysis comprised of 241 patients. Of the total 278 patients, 174 (63%) were males. Rapid sequence intubation was the commonest type (n=185, 67%) of intubation and was performed mostly by anaesthetists (n=236, 85%). Cardiogenic pulmonary oedema and head injury were commonly seen in these patients. The success on first attempt of intubation was 98% (n=181) in rapid sequence intubation, and 85% (n=48) in crash intubation. Overall, 15 (5.3%) complications were seen in these intubations. Conclusion: Study showed a satisfactory success rate in both rapid sequence and crash intubations.