Factors associated with first-pass success of emergency endotracheal intubation
| Autor: | Whei Jung, Joonghee Kim |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care Patient characteristics Endotracheal intubation Logistic regression Tongue Republic of Korea medicine Intubation Intratracheal Edema Humans Facial Injuries Aged Retrospective Studies First pass Aged 80 and over Mouth Adult patients business.industry Internship and Residency General Medicine Emergency department Middle Aged Mouth opening medicine.anatomical_structure Emergency medicine Emergency Medicine Female Clinical Competence business Emergency Service Hospital Neck |
| Zdroj: | The American journal of emergency medicine. 38(1) |
| ISSN: | 1532-8171 |
| Popis: | Study objective Endotracheal intubation is frequently performed in emergency departments (EDs). First-pass success is important because repeated attempts are associated with poor outcomes. We sought to identify factors associated with first-pass success in emergency endotracheal intubation. Methods We analyzed emergency orotracheal intubations on adult patients in an ED located in South Korea from Jan. 2013 to Dec. 2016. Various operator-, procedure- and patient-related factors were screened with univariable logistic regression. Using variables with P-values less than 0.2, a multiple logistic regression model was constructed to identify independent predictors. Results There were 1154 eligible cases. First-pass success was achieved in 974 (84.4%) cases. Among operator-related factors, clinical experience (OR: 2.93, 5.26, 3.80 and 5.71; 95% CI: 1.62–5.26, 2.80–9.84, 1.81–8.13 and 2.07–18.67 for PGY 3, 4 and 5 residents and EM specialists, respectively, relative to PGY 2 residents) and physician based outside the ED (OR: 0.10; 95% CI: 0.04–0.25) were independently associated with first-pass success. There was no statistically or clinically significant difference for first-pass success rate as determined by operator's gender (83.6% for female vs. 84.8% for male; 95% CI for difference: −3.1% to 5.8%). Among patient-related factors, restricted mouth opening (OR: 0.47; 95% CI: 0.31–0.72), restricted neck extension (OR: 0.57; 95% CI: 0.39–0.85) and swollen tongue (OR: 0.46; 95% CI: 0.28–0.77) were independent predictors of first-pass success. Conclusions Operator characteristics, including clinical experience and working department, and patient characteristics, including restricted mouth opening, restricted neck extension and swollen tongue, were independent predictors of first-pass success in emergency endotracheal intubation. |
| Databáze: | OpenAIRE |
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