A prospective study of tracheal intubation in an academic emergency department in Malaysia

Abstract

BackgroundAirway management is an important part of the management of the critically ill and injured patients in the Emergency Department (ED). Numerous studies from developed countries have demonstrated the competency of emergency doctors in intubation. To date there have been no published data on intubations performed in EDs in Malaysia.MethodsData on intubations from 7 August 2007 till 28 August 2008 were prospectively collected.ResultsThere were 228 intubations included in the study period. Cardiopulmonary arrest was the main indication for intubation (35.5%). The other indications were head injury (18.4%), respiratory failure (15.4%), polytrauma (9.6%) and cerebrovascular accident (7.0%). All of the 228 patients were successfully intubated. Rapid sequence intubation (RSI) was the most frequent method (49.6%) of intubation. A total of 223 (97.8%) intubations were done by ED personnel. In 79.8% of the cases, intubations were successfully performed on the first attempt. Midazolam was the most common induction agent used (97 patients), while suxamethonium was the muscle relaxant of choice (109 patients). There were 34 patients (14.9%) with 38 reported immediate complications. The most common complication was oesophageal intubation.ConclusionEmergency Department UKMMC personnel have a high competency level in intubation with an acceptable complication rate. RSI was the most common method for intubation.

Systematic review and meta‐analysis of first‐pass success rates in emergency department intubation: Creating a benchmark for emergency airway care

“…The full texts of 83 potentially eligible studies were obtained. After exclusion of all non‐relevant papers, 16 studies were included in the ‘ED‐All’ group . These reported a total of 42 081 airway encounters from 83 EDs, in 10 countries.…”

Tracheal intubation in an urban emergency department in Scotland: A prospective, observational study of 3738 intubations

“…Studies from North America and Asia have demonstrated variable success and complication rates of RSI performed by emergency physicians. [10][11][12][13][14][15][16][17] There are limited data from the UK 4,5 so we reviewed our continuous registry of intubations in a large UK ED to characterise intubation sequences, success and complications. Our aims were to describe why, how and by whom ED patients were intubated, and to document the rates of successful intubation and complications related to the procedure.…”

Effect of positive end-expiratory pressure value on change in end-tidal carbon dioxide as a predictor of fluid responsiveness in Patients Undergoing Passive Leg Raising Maneuver

“…The median age of subjects in this study is 51.5 years. Three other studies about intubation in the emergency room in Asian hospitals get lower median age (Fathil et al, 2010;Tam & Lau, 2001;Wong et al, 2004).…”