Airway management practices among emergency physicians: An observational study

Area of Science:

• Emergency Medicine
• Critical Care
• Anesthesiology

Background:

• Emergency airway management is crucial for patient stabilization.
• Limited research exists on airway practices in low-to-middle-income countries like India.
• Emergency Medicine as a specialty is developing in India.

Purpose of the Study:

• To identify current emergency airway management practices in a tertiary care center in India.
• To analyze the techniques, medications, and outcomes of emergency endotracheal intubation.
• To provide data that could inform national airway registries and quality improvement initiatives.

Main Methods:

• Prospective, observational study in an emergency department over 16 months.
• Included 166 patients undergoing emergency endotracheal intubation.
• Collected data on patient demographics, intubation indications, methods, medications, physician specialty, checklists, vitals, and adverse events.

Main Results:

• Rapid sequence intubation (RSI) was used in 72.9% of cases, primarily with etomidate and rocuronium.
• Direct laryngoscopy was the predominant technique (95%).
• First-pass success rate was 78.3%, with a 58.4% incidence of adverse events (desaturation, mainstem intubation, equipment failure).

Conclusions:

• RSI is the most frequent method for emergency airway management.
• Significant heterogeneity exists in practices and associated complications.
• Regular surveillance, quality improvement, and enhanced training are essential for optimal patient care.