Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital

Emerg Med Australas. 2014 Aug;26(4):368-75. doi: 10.1111/1742-6723.12257. Epub 2014 Jun 16.

Abstract

Objective: The present study aimed to describe the characteristics and outcomes of intubation occurring in the ICU and ED of an Australian tertiary teaching hospital.

Methods: This was a prospective observational study of intubation practice across the Geelong Hospital over a 6 month period from 1 August 2012 to 31 January 2013. Data were entered by the intubating team through an online data collection form.

Results: There were 119 patients intubated and 134 attempts at intubation in the ED and ICU over a 6 month period. The first-pass success rate was 104/119 (87.4%), and all but a single patient was intubated by the second attempt. Propofol, fentanyl, midazolam and suxamethonium were the most common drugs used in rapid sequence induction. AEs were reported in 44/134 (32.8%) of intubation attempts, with transient hypoxia and hypotension being the most common. A significant adverse outcome, namely aspiration pneumonitis, occurred in one patient. There were no peri-intubation deaths.

Conclusion: The majority of airways are managed by ICU and ED consultants and trainees, with success rates and AE rates comparable with other published studies.

Keywords: airway management; critical care; emergency medicine; intensive care; intubation.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Airway Management / adverse effects
  • Airway Management / methods*
  • Australia
  • Clinical Audit
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Intubation, Intratracheal / methods
  • Intubation, Intratracheal / statistics & numerical data*
  • Male
  • Middle Aged
  • Prospective Studies