Emergency room intubations--complications and survival

Area of Science:

• Emergency Medicine
• Critical Care
• Respiratory Therapy

Background:

• Endotracheal intubation is a common emergency room procedure.
• Complications and survival rates associated with emergency intubation require further definition.
• Evaluating current emergency room policies for intubation is essential.

Purpose of the Study:

• To define complications associated with emergency room endotracheal intubation.
• To determine patient survival rates following emergency intubation.
• To evaluate the effectiveness of current emergency room intubation policies.

Main Methods:

• Prospective study of 43 consecutive patients requiring endotracheal intubation in an emergency room.
• Data collected on indications for intubation (acute respiratory failure vs. cardiopulmonary arrest), complications, and survival.
• Analysis of factors influencing complication rates and survival, including intubator training and patient condition.

Main Results:

• Thirty-eight complications occurred in 24 of 43 patients.
• Intubator's department or training level did not impact complication rates.
• Seventeen patients survived, all from the acute respiratory failure group; younger age and higher admission PaO2 were linked to better survival.

Conclusions:

• The complication rate for emergency room intubations is high.
• Limiting intubations to specific physician groups or training levels does not appear to reduce complications.
• Underlying diagnosis and patient's condition on admission are more critical for survival than intubation-related complications.