Rapid sequence intubation of trauma patients in Scotland
| Autor: | Colin A. Graham, Dermot W. McKeown, D. Beard, Jennifer M. Henry |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Resuscitation medicine.medical_specialty medicine.medical_treatment Laryngoscopy Conscious Sedation Critical Care and Intensive Care Medicine Statistics Nonparametric Injury Severity Score Anesthesiology medicine Intubation Intratracheal Intubation Humans Prospective Studies Practice Patterns Physicians' Hospitals Teaching Emergency Treatment Medical Audit medicine.diagnostic_test business.industry Multiple Trauma Patient Selection Gold standard Drug Utilization Treatment Outcome Scotland Anesthesia Health Care Surveys Orthopedic surgery Emergency medicine Emergency Medicine Surgery Airway management Female Neuromuscular Blocking Agents business Airway Emergency Service Hospital |
| Zdroj: | The Journal of trauma. 56(5) |
| ISSN: | 0022-5282 |
| Popis: | Background: Endotracheal intubation remains the gold standard for trauma airway management. Rapid sequence intubation (RSI) has traditionally been performed by anesthesiologists but increasingly, emergency physicians are also undertaking RSI. We aimed to compare success and complication rates for trauma intubations for the two specialties. Methods: Two year, prospective multi-center descriptive study of trauma RSI in seven Scottish urban emergency departments. Results: 439 trauma patients were identified, including 233 RSIs. Patients intubated by emergency physicians had a higher median ISS (p < 0.001) and lower median RTS (p < 0.001) compared with anesthesiologists. For RSI, anesthesiologists had more grade I & II views at laryngoscopy (p = 0.051) and more successful first attempt intubations (p = 0.034) but there was no difference in the number of patients suffering complications (emergency physicians 10.0%, anesthesiologists 10.6%). Conclusion: There is no significant difference in complication rates for trauma RSI between emergency physicians and anesthesiologists in Scottish urban centers. A collaborative approach to the critical trauma airway is vital. Emergency physicians should consult with senior anesthesiologists before RSI when intubation is predicted to be difficult. |
| Databáze: | OpenAIRE |
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