Emergency Department Versus Operating Suite Intubation in Operative Trauma Patients: Does Location Matter?

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Critical Care

Background:

• Reducing time to definitive surgical care improves outcomes for injured patients.
• Intubation location (emergency department vs. operating suite) may impact surgical care timelines.
• This study investigates the effect of intubation site on time to definitive surgical care in trauma patients.

Purpose of the Study:

• To compare the time to definitive surgical care for injured patients intubated in the emergency department versus the operating suite.
• To determine if emergency department intubation is associated with shorter times to definitive surgical care.
• To assess the safety of emergency department intubation in trauma patients.

Main Methods:

• Retrospective analysis of 241 injured patients undergoing emergency surgery (2010-2017).
• Patients with preoperative emergency department dwell time < 30 minutes were included.
• Multivariable regression analyzed the association between intubation location and time to definitive surgical care.

Main Results:

• No significant difference in time to definitive surgical care between emergency department (41 min) and operating suite (43 min) intubation groups (p=0.064).
• Emergency department intubation was associated with a higher incidence of post-intubation traumatic cardiopulmonary arrest (8.0% vs. 0.9%, p=0.014).
• Multivariable analysis confirmed emergency department intubation was not associated with reduced time to definitive care (p=0.386).

Conclusions:

• Intubation in the emergency department did not decrease the time to definitive surgical care for injured patients.
• Emergency department intubation in this trauma cohort was associated with an increased risk of post-intubation traumatic cardiopulmonary arrest.
• The findings suggest that emergency department intubation does not offer a time advantage and may carry increased risks.