A prospective observational study of tracheal intubation in an emergency department in a 2300-bed hospital of a developing country in a one-year period

Wongyingsinn, Mingkwan; Songarj, Phuriphong; Assawinvinijkul, T.

doi:10.1136/emj.2008.061192

Cited by 21 publications

(21 citation statements)

References 18 publications

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“…The first priority for managing an acutely unstable patient is securing the airway. Approximately 0.5–1% of emergency department (ED) patients require intubation for various conditions, such as respiratory failure, cardiac arrest, and altered mental status . Emergency airway management in the ED is often challenging for the emergency physician because multiple ED‐specific factors, for example, vomiting, facial/neck trauma, immobilized cervical spine, and chest compression for resuscitation, contribute to intubation success and failure.…”

Section: Introductionmentioning

confidence: 99%

Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

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Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse event rates with a wide variation across the EDs. The optimal emergency airway management strategies remain to be established and their dissemination to the entire nation is a challenging task. This article reviews the current published works on emergency airway management with a focus on the use of airway management algorithms as well as the importance of first‐pass success and systematic use of rescue intubation strategies. Additionally, the review summarizes the current evidence for each of the important airway management processes, such as assessment of the difficult airway, preparation (e.g., positioning and oxygenation), intubation methods (e.g., rapid sequence intubation), medications (e.g., premedications, sedatives, and neuromuscular blockades), devices (e.g., direct and video laryngoscopy and supraglottic devises), and rescue intubation strategies (e.g., airway adjuncts and rescue intubators), as well as the airway management in distinct patient populations (i.e., trauma, cardiac arrest, and pediatric patients). Well‐designed, rigorously conducted, multicenter studies that prospectively and comprehensively characterize emergency airway management should provide clinicians with important opportunities for improving the quality and safety of airway management practice. Such data will not only advance research into the determination of optimal airway management strategies but also facilitate the development of clinical guidelines, which will, in turn, improve the outcomes of critically ill and injured patients in the ED.

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Section: Introductionmentioning

confidence: 99%

Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

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“…Airway management is a fundamental aspect of many of the major resuscitations that take place in our EDs and a skill that emergency physicians (EPs) should deliver in a safe and timely manner. A number of observational studies have been published describing how this practice is performed in EDs across the world either at a single or multicentre level. Following the publication of data on ED intubation from our institution, it was decided to implement a bundle of changes to our practice in order to improve patient safety.…”

Section: Introductionmentioning

confidence: 99%

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

Fogg

Alkhouri²,

Vassiliadis

2015

Emerg Medicine Australasia

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Objective We aim to investigate whether a bundle of changes made to the practice of endotracheal intubation in our ED was associated with an improvement in first pass success rate and a reduction in the incidence of complications. Methods We used a prospective observational study. Results The data on 360 patients who were intubated during an 18‐month period following the introduction of these changes were compared with our previously published observational data. Success on first attempt at intubation improved 83.4% to 93.9% (P < 0.0001). The proportion of patients with one or more complication fell from 29.0% to 19.4% (P < 0.042). Oesophageal intubation fell from 4.0% to 0.3% (P < 0.001), and there was a non‐significant reduction in the rate of desaturation, from 15.6% to 10.9% (P < 0.07). Conclusion We have shown that, through the introduction of a bundle of changes that spans the domains of staff training, equipment and practice standardisation, we have made significant improvements in the safety of patients undergoing endotracheal intubation in our ED.

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“…The 24 articles chosen for final review are listed in Table 2 below and the references section 11–34 . An annotated bibliography including final summary and critical analysis of each article can be found in Data Supplement S1 (available as supporting information in the online version of this paper).…”

Section: Resultsmentioning

confidence: 99%

“…Another crucial topic is development of EM skills among already practicing clinicians. Wongyingsinn et al 34 demonstrated progress on this front by studying emergency department intubations by EM residents and EM staff physicians at a tertiary academic medical center in Thailand, finding success rates comparable to those in developed countries, despite areas for improvement including low rates of utilization of neuromuscular blockade, high rates of soft tissue injury, and no use of awake fiberoptic techniques.…”

Section: Discussionmentioning

confidence: 99%

International Emergency Medicine: A Review of the Literature From 2009

Foran¹,

Levine²,

Lippert³

et al. 2010

Academic Emergency Medicine

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As the specialty of emergency medicine evolves in countries around the world, and as interest in international emergency medicine (IEM) grows within the United States, the IEM Literature Review Group recognizes an ongoing need for a high-quality, consolidated, and easily accessible evidence base of literature. The IEM Literature Review Group produces an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research from the previous year. This publication represents our fifth annual review, covering the top 24 IEM research articles published in 2009. Articles were selected for the review according to explicit, predetermined criteria that emphasize both methodologic quality and impact of the research. It is our hope that this annual review acts as a forum for disseminating best practices, while also stimulating further research in the field of IEM.ACADEMIC EMERGENCY MEDICINE 2011; 18:86-92 ª 2011 by the Society for Academic Emergency Medicine I n 2009, the H1N1 influenza pandemic captured the attention of practitioners of international emergency medicine (IEM) and the public at large. As the virus overwhelmed initial attempts at containment, the medical and public health communities responded with an explosion of research on the virus, vaccine development, and preparation for future pandemics. 1Together with this ''swine flu'' pandemic, natural disasters and complex emergencies, such as the Australian bushfires 2 and Sri Lankan conflict, 3 continued to fuel interest in the growing field of IEM, which now offers 25 fellowships in the United States. 4 The year 2009 also witnessed spikes in violence and acute undernutrition in sites of chronic humanitarian crises such as the Democratic Republic of Congo, 5 Sudan, 6 and Somalia, 7 underscoring the need for attention to humanitarian response, improvement in provision of emergency care in resource-limited settings, and support for the development of EM throughout the world.As the specialty of IEM continues to evolve, the IEM Literature Review Group strives to provide readers with summaries of the highest quality and most relevant IEM research. Our review, now in its fifth year, annually compiles a diverse array of articles that have the potential to impact some aspect of IEM. This publication is neither intended to serve as a systematic review for clinical guidance, nor is it a comprehensive repository of all literature relevant to IEM. Rather, we hope that this review will help IEM academicians and practitioners stay up to date on the latest research in the field, while spurring ideas for further research and collaboration.This year, defining the boundaries of the field of IEM remained one of our greatest challenges. With the arrival of the H1N1 pandemic, the volume of articles published that could be categorized as related to pandemic response rose exponentially. To prevent this vast new literature from overwhelming our review, we chose to only include pandemic response articles directly related to one of ...

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A prospective observational study of tracheal intubation in an emergency department in a 2300-bed hospital of a developing country in a one-year period

Abstract: At this institution, the majority of ED intubations were performed by residents and no drug was used. In this ED patients were intubated with a high success rate and a low rate of serious complications.

Cited by 21 publications

References 18 publications

Advancing emergency airway management practice and research

Advancing emergency airway management practice and research

The Royal North Shore Hospital Emergency Department airway registry: Closing the audit loop

International Emergency Medicine: A Review of the Literature From 2009

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