Surgical airway in emergency department intubation
| Autor: | Angela J. Oglesby, Dermot W. McKeown, Lindsay A. Reid, Mark Dunn |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Surgical airway medicine.medical_treatment Critical Illness MEDLINE Endotracheal intubation Perioperative Care Young Adult medicine Confidence Intervals Intubation Intratracheal Intubation Humans Glasgow Coma Scale Prospective Studies Prospective cohort study business.industry General surgery Emergency department respiratory system Middle Aged Rapid sequence induction humanities respiratory tract diseases Scotland Surgical Procedures Operative Emergency Medicine Female business Emergency Service Hospital |
| Zdroj: | European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 18(3) |
| ISSN: | 1473-5695 |
| Popis: | Objectives To determine the frequency of and primary indication for surgical airway during emergency department intubation. Methods Prospectively collected data from all intubations performed in the emergency department from January 1999 to July 2007 were analysed to ascertain the frequency of surgical airway access. Original data were collected on a structured proforma, entered into a regional database and analysed. Patient records were then reviewed to determine the primary indication for a surgical airway. Results Emergency department intubation was undertaken in 2524 patients. Of these, only five patients (0.2%) required a surgical airway. The most common indication for a surgical airway was trauma in four of the five patients. Two patients had attempted rapid sequence induction before surgical airway. Two patients had gaseous inductions and one patient received no drugs. In all five patients, surgical airway was performed secondary to failed endotracheal intubation attempt(s) and was never the primary technique used. Conclusion In our emergency department, surgical airway is an uncommon procedure. The rate of 0.2% is significantly lower than rates quoted in other studies. The most common indication for surgical airway was severe facial or neck trauma. Our emergency department has a joint protocol for emergency intubation agreed by the Departments of Emergency Medicine, Anaesthesia and Critical Care at the Edinburgh Royal Infirmary. We believe that the low surgical airway rate is secondary to this collaborative approach. The identified low rate of emergency department surgical airway has implications for training and maintenance of skills for emergency medicine trainees and physicians. |
| Databáze: | OpenAIRE |
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