An analysis of emergency tracheal intubations in critically ill patients by critical care trainees

Arulkumaran, Nishkantha, McLaren, Charles S, Arulkumaran, Kailash, Philips, Barbara J and Cecconi, Maurizio (2018) An analysis of emergency tracheal intubations in critically ill patients by critical care trainees. Journal of the Intensive Care Society, 19 (3). pp. 180-187. ISSN 1751-1437

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Abstract

Introduction
We evaluated intensive care medicine trainees' practice of emergency intubations in the United Kingdom.

Methods
Retrospective analysis of 881 in-hospital emergency intubations over a three-year period using an online trainee logbook.

Results
Emergency intubations out-of-hours were less frequent than in-hours, both on weekdays and weekends. Complications occurred in 9% of cases, with no association with time of day/day of week (p = 0.860). Complications were associated with higher Cormack and Lehane grades (p=0.004) and number of intubation attempts (p < 0.001), but not American Society of Anesthesiologist grade. Capnography usage was ≥99% in all locations except in wards (85%; p = 0.001). Ward patients were the oldest (p < 0.001), had higher American Society of Anesthesiologist grades (p < 0.001) and lowest Glasgow Coma Scale (p < 0.001).

Conclusions
Complications of intubations are associated with higher Cormack and Lehane grades and number of attempts, but not time of day/day of week. The uptake of capnography is reassuring, although there is scope for improvement on the ward.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Clinical and Experimental Medicine
Subjects: R Medicine > RC Internal medicine > RC0086 Medical emergencies. Critical care. Intensive care. First aid
Depositing User: Ellen Thomas
Date Deposited: 15 May 2019 11:21
Last Modified: 01 Jul 2019 15:02
URI: http://sro.sussex.ac.uk/id/eprint/83429

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