The Bougie and First-Pass Success in the Emergency Department
| Autor: | John W. McGill, Robert F. Reardon, Brian E. Driver, Matthew E. Prekker, Lauren R. Klein, Aaron E. Robinson, Kenneth W. Dodd, Ryan Buckley |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Video Recording Patient Positioning 03 medical and health sciences 0302 clinical medicine medicine Airway anatomy Intubation Intratracheal Intubation Humans 030212 general & internal medicine Retrospective Studies Video recording First pass Laryngoscopy business.industry Sniffing position 030208 emergency & critical care medicine Retrospective cohort study Emergency department Middle Aged Confidence interval Surgery Treatment Outcome Anesthesia Emergency Medicine Female business Emergency Service Hospital |
| Zdroj: | Annals of emergency medicine. 70(4) |
| ISSN: | 1097-6760 |
| Popis: | Study objective The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. Methods We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation. Results Intubation with a Macintosh blade was attempted in 543 cases; a bougie was used on the majority of initial attempts (80%; n=435). First-pass success was greater with than without bougie use (95% versus 86%; absolute difference 9% [95% confidence interval {CI} 2% to 16%]). The median first-attempt duration was higher with than without bougie (40 versus 27 seconds; difference 14 seconds [95% CI 11 to 16 seconds]). Bougie use was independently associated with greater first-pass success (adjusted odds ratio 2.83 [95% CI 1.35 to 5.92]). Conclusion Bougie was associated with increased first-pass intubation success. Bougie use may be helpful in ED intubation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect