For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
0
views
29
references
 Top references
cited by
3
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      65
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Comparison of the outcome of emergency endotracheal intubation in the general ward, intensive care unit and emergency department

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Emergency endotracheal intubations outside the operating room (OR) are associated with high complications. We compare the outcome of emergency endotracheal intubation in the general ward, the intensive care unit (ICU) and the emergency department (ED).

          Methods

          We retrospectively analyzed adult patients requiring emergency endotracheal intubation that called for anesthesiologists at our tertiary care institution from January 1, 2015 to December 31, 2016. We evaluated the outcomes, including aspiration, hemodynamic collapse, pneumothorax, emergency tracheostomy, and survival to hospital discharge in the general ward, ICU, and ED.

          Results

          There were 416 non-OR emergency endotracheal intubation calls for the anesthesiologist. Among these areas, the ED had the highest proportion of difficult endotracheal (DET) intubation (n = 144 [80.4%]), followed by the general ward (n = 85 [66.4%]), and then the ICU (n = 65 [59.6%]). The incidence of hemodynamic collapse was higher in the general ward (n = 44 [34.4%]) than the ICU (n = 18 [16.5%]) or the ED (n = 16 [9.0%]). We reported the survival rate of the general ward (55.5%), which was lower than the ICU (63.3%) and the ED (80.4%). Among these locations, the ED had the highest rate of neurologically intact (91%) to hospital discharge, compared to the ICU (56.6%) and the general ward (55%). As for the ED, although there was no difference in survival between non-preventive and preventive intubations, preventive intubations was associated with high neurological intact with hospital discharge.

          Conclusion

          Emergency and DET intubation in the general ward and ICU resulted in a higher incidence of hemodynamic collapse and mortality than those performed in the ED. Early calls for the anesthesiologist for DET intubation without medications in the ED resulted in a higher rate of neurologically intact survival to hospital discharge.

          Related collections

          Most cited references29

          • Record: found
          • Abstract: found
          • Article: not found

          Techniques, success, and adverse events of emergency department adult intubations.

          Calvin Brown, Aaron Bair, Daniel J Pallin … (2015)
          We describe the operators, techniques, success, and adverse event rates of adult emergency department (ED) intubation through multicenter prospective surveillance.
          Article 0 comments Cited 99 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A systematic review of the Charlson comorbidity index using Canadian administrative databases: a perspective on risk adjustment in critical care research.

            M. Needham, Damon C Scales, Andreas Laupacis … (2005)
            The Charlson index is commonly used for risk adjustment in critical care health services research. However, the literature supporting this methodology has not been thoroughly explored. We systematically reviewed the literature related to administrative database adaptations of the Charlson index. Our review has 3 major findings. First, 2 studies compared Canadian administrative databases with chart review for obtaining Charlson comorbidity data. Agreement between the database and chart review was substantial (kappa > 0.70), and mortality prediction did not differ. Second, 5 database adaptations were identified with the Deyo and Dartmouth-Manitoba adaptations being most popular. Three studies directly compared these 2 popular adaptations and demonstrated substantial agreement (kappa > 0.70) and similar predictive ability for mortality. Third, one study validated the Charlson index for critically ill patients but demonstrated that APACHE (Acute Physiology and Chronic Health Evaluation) II better discriminates inhospital mortality (area under curve 0.67 vs 0.87). Time and cost barriers prevent widespread use of physiology-based risk adjustment in population-based research. The decreased predictive ability of the Charlson index must be weighed against the advantages of using this instrument for population-based research. Future research should focus on updating the Charlson index for recent changes in the prognosis of comorbid diseases and introduction of International Statistical Classification of Diseases, 10th Revision coding of discharge abstracts.
            Article 0 comments Cited 93 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts.

              D Barton, F. M. Garay Walls, Seo Yi Chng … (2005)
              We determine success rates of endotracheal intubation performed in emergency departments (EDs) by North American emergency medicine residents. During 58 months, physicians performing intubations at 31 university-affiliated EDs in 3 nations completed a data form that was entered into the National Emergency Airway Registry 2 database. Included were all patients undergoing endotracheal intubation in the ED. The data form included patients' age, sex, weight, indication for intubation, technique of airway management, names and dosages of all medications used to facilitate intubation, level of training and specialty of the intubator, number of attempts, success or failure, and adverse events. We queried this prospectively gathered, observational data to analyze intubations done by US and Canadian emergency medicine residents. Enrollment was incomplete (eg, 85% at the main study center), so the study sample did not include all consecutive patients. Emergency medicine residents performed 77% (5768/7498; 95% confidence interval [CI] 76% to 78%) of all initial intubation attempts in the United States and Canada. The first intubator was successful in 90% (5,193/5,757; 95% CI 89% to 91%) of cases, including 83% (4,775/5,757; 95% CI 82% to 84%) on the first attempt. Success rates on the first attempt were as follows: postgraduate year 1 = 72% (498/692; 95% CI 68% to 75%), postgraduate year 2 = 82% (2,081/2,544; 95% CI 80% to 83%), postgraduate year 3 = 88% (1,963/2,238; 95% CI 86% to 89%), postgraduate year 4+ = 82% (233/283; 95% CI 77% to 87%), and attending physician = 89% (689/772; 95% CI 87% to 91%). Success rates by the first intubator were as follows: postgraduate year 1 = 80% (553/692; 95% CI 77% to 83%), postgraduate year 2 = 89% (2,272/2,544; 95% CI 88% to 90%), postgraduate year 3 = 94% (2,105/2,238; 95% CI 93% to 95%), postgraduate year 4+ = 93% (263/283; 95% CI 89% to 96%), and attending physician = 98% (755/772; 95% CI 96% to 99%). Rapid sequence intubation technique was used in 78% (4,513/5,768; 95% CI 77% to 79%) of initial attempts: it resulted in 85% (3,843/4,513; 95% CI 84% to 86%) success on the first attempt and 91% (4,117/4,513; 95% CI 90% to 92%) success by the first intubator. The overall rate of cricothyrotomy for all emergency resident intubations was 0.9% (50/5,757; 95% CI 0.6% to 1.1%). When an initial intubator failed, 40% (385/954; 95% CI 37% to 44%) of rescue attempts were performed by emergency medicine residents. Among emergency medicine residents, success on the first rescue attempt was 80% (297/371; 95% CI 76% to 84%), and success by the first rescue intubator was 88% (328/371; 95% CI 85% to 91%). Success of initial intubation attempts increased over the first 3 years of residency. This large multicenter study demonstrates the success of airway management by emergency medicine residents in North America. Using rapid-sequence intubation predominantly, emergency medicine residents achieved high levels of success.
              Article 0 comments Cited 82 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                An-Hsun Chou
                Journal
                Journal ID (nlm-ta): Biomed J
                Journal ID (iso-abbrev): Biomed J
                Title: Biomedical Journal
                Publisher: Chang Gung University
                ISSN (Print): 2319-4170
                ISSN (Electronic): 2320-2890
                Publication date PMC-release: 27 July 2020
                Publication date (Print): December 2021
                Publication date (Electronic): 27 July 2020
                Volume: 44
                Issue: 6 Suppl 1
                Pages: S110-S118
                Affiliations
                [a ]Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
                [b ]College of Medicine, Chang Gung University, Taoyuan, Taiwan
                [c ]Department of Management, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
                [d ]Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
                [e ]Department of Anesthesiology, Xiamen Chang Gung Hospital, Xiamen, China
                Author notes
                [∗ ] Corresponding author. Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou, 5, Fusing St., Gueishan, Taoyuan, Taiwan. f5455@ 123456cgmh.org.tw
                Article
                Publisher Item ID: S2319-4170(20)30124-4
                DOI: 10.1016/j.bj.2020.07.006
                PMC ID: 9038942
                PubMed ID: 35735080
                SO-VID: 439c647f-c0fb-44b3-a7d1-01888225a970
                Copyright © © 2020 Chang Gung University. Publishing services by Elsevier B.V.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 3 January 2019
                Date accepted : 22 July 2020
                Categories
                Subject: Original Article

                Keywords: general ward,intensive care unit,emergency department,difficult endotracheal intubation
                Data availability:
                Keywords: general ward, intensive care unit, emergency department, difficult endotracheal intubation

                Comments

                Comment on this article

                scite_

                Similar content65

                See all similar

                Cited by3

                See all cited by

                Most referenced authors268

                See all reference authors