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Related Experiment Videos

Analysis of trauma intubations.

J L Oswalt1, J R Hedges, B E Soifer

  • 1Department of Emergency Medicine, Washoe Medical Center, Reno, NV.

The American Journal of Emergency Medicine
|November 1, 1992
PubMed
Summary

Timely intubation for trauma patients doesn't always impact outcomes like hospital stay or pneumonia. However, specific patient factors like low Glasgow Coma Scale (GCS) scores and older age with rapid breathing may indicate a need for closer monitoring and potential audit filters.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Critical Care

Background:

  • Intubation timing in trauma patients is a critical decision influenced by clinical status and provider judgment.
  • Optimal timing aims to improve patient outcomes but requires clear guidelines.

Purpose of the Study:

  • To correlate the timing of endotracheal intubation in trauma patients with presenting physiological parameters and clinical outcomes.
  • To identify potential quality assurance audit filters for trauma intubation.

Main Methods:

  • Retrospective analysis of 82 trauma patients categorized by intubation timing: prehospital, immediate (<10 min), delayed (>10 min to 2 hours), and non-urgent (>2 hours or at surgery).
  • Comparison of Revised Trauma Scores (RTS), Glasgow Coma Scale (GCS), length of hospital stay, aspiration pneumonia incidence, and survival rates.

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  • Analysis of specific patient characteristics within each group.

    • Main Results:

    • While mean RTS and GCS scores varied across groups, length of stay and aspiration pneumonia rates were not significantly different.
    • In the delayed intubation group, 80% of patients who developed aspiration pneumonia had a GCS ≤ 13.
    • The non-urgent intubation group included older patients with tachypnea, and their survival rate was lower than predicted by TRISS methodology (P = .004).

    Conclusions:

    • A GCS score of 13 or less, combined with age over 50 and respiratory rates exceeding 25 breaths/min, may serve as potential audit filters for trauma intubation.
    • These findings suggest specific clinical indicators that warrant closer scrutiny in trauma care quality assurance.