The Success of Emergency Endotracheal Intubation in Trauma Patients: A 10-Year Experience at a Major Adult Trauma Referral Center

Stephens, Christopher T.; Kahntroff, Stephanie; Dutton, Richard P.

doi:10.1213/ane.0b013e3181ad87b0

Cited by 103 publications

(58 citation statements)

References 21 publications

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“…[12] This retrospective survey, the largest reported, confirms an overall high success rate, with no patient dying of a hypoxic cardiac arrest during airway management. Of note, a mere 21 patients required an emergency cricothyroidotomy or tracheotomy.…”

Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)supporting

confidence: 61%

“…Of note, a mere 21 patients required an emergency cricothyroidotomy or tracheotomy. [12] Despite obvious limitations to this study (retrospective, specialist trauma centre, resource-rich setting), the results are compelling.…”

Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)mentioning

confidence: 88%

“…the University of Maryland (Baltimore, USA), as well as incorporating elements of the EMSSA protocol. [7,12] It is a simplification of these guidelines and adapted for use in the rural hospital trauma setting, in a situation where loss of the airway is imminent and the option to reverse the anaesthetic, as well as awaken the patient, is not possible. The protocol takes into account that the operator may only have basic skills.…”

Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)mentioning

confidence: 99%

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Simplifying trauma airway management in South African rural hospitals

Berry

Wood

2014

S Afr Med J

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Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)supporting

confidence: 61%

Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)mentioning

confidence: 88%

Section: Corresponding Author: M Berry (Michaelberry1@nhsnet)mentioning

confidence: 99%

See 1 more Smart Citation

Simplifying trauma airway management in South African rural hospitals

Berry

Wood

2014

S Afr Med J

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“…Our study revealed that four of 554 trauma patients (0.72%) received ESA in emergency surgery settings (odds ratio: 28.9-144.1). In the field of emergency medicine, studies have found that 0.3-0.9% of trauma patients received CTY in pre-hospital or ER settings [3][4][5][6]. Severe facial injury patients received ESA more often than did patients with other types of trauma.…”

Section: Discussionmentioning

confidence: 99%

Surgical airways for trauma patients in an emergency surgical setting: 11 years’ experience at a teaching hospital in Japan

Ono¹,

Yokoyama²,

Matsumoto³

et al. 2013

J Anesth

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Purpose Airway management of trauma patients during emergency surgeries can be very difficult, and presents a challenge for anesthesiologists. Difficult airways are associated with emergency surgical airways (ESA), but little is known about ESA in the operating room. We conducted this study to clarify the present use of ESA for trauma patients in emergency surgery settings. MethodsWe performed a retrospective review of all trauma patients requiring emergency surgery under general anesthesia at our hospital from January 2002 to December 2012, and focused on ESA.Results During the study period, 15,654 trauma patients were treated at our hospital, of whom 554 (3.5%) required emergency surgery. Four of these (0.72%) received ESA as definitive airway management. Two patients with severe facial injury and distorted upper airways and one patient with penetrating neck trauma received open standard tracheostomies (OST). These three patients received OST as the initial approach to intubation. A fourth OST was performed after several unsuccessful attempts at endotracheal intubation. No cases were classified as "cannot ventilate, cannot intubate" (CVCI), and there were no complications associated with ESA. All cases had good outcomes.Statistical analysis revealed that patients with severe facial trauma (Abbreviated Injury Scale ≥ 3) received ESA at a significantly higher rate than others (p=0.015, Odds ratio: 14.1). ConclusionOne of the most important functions of anesthesiologists is risk management. We should recognize risks that can cause CVCI situations, and make proper clinical decisions, including 3 providing ESA, to assure patient safety.4

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“…Eğer hava yolu sağlanmasında; resüsitatif çabalar içinde acil ETE gereksinimi yoksa, hastanın hava yolunu güçlük olasılığına göre değerlendirmek için zaman vardır. Zorluk, hastanın işbirliğine, maske ile havalandırılabilmesine, supraglottik hava yolu gereci yerleşimine, laringoskopi, ETE ve cerrahi hava yolu sağlamadaki zorluklara bağlı olabilir (24) .…”

Section: Introductionunclassified

Safely Airway Management in Larinks and Tracheobronchial Injuries

Demirgan¹,

Mingir²,

Kerem³

2017

Okmeydani Medical Journal

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ÖZ GİRİŞTravma, dünyadaki her 10 ölümün yaklaşık 1' ine neden olan önemli ve uluslararası bir sorundur(1) . Bü-yük ölçüde genç nüfusu etkiler. On beş-elli dokuz yaş grubunda, tüm ölümlerin %13-29' undan sorumludur. Travmada ölüm genellikle (%20-86) hastane öncesi ortamda meydana gelir (2) . Özellikle erken ve etkili güvenli hava yolu desteğinin, travmazedelerin yaşamda kalmasını artırabileceğine yönelik çok sayıda teorik ve niceliksel kanıt bulunmaktadır. Hastaneye varmış politravma hastalarının morbidite ve mortalitesi genellikle hava yolu yönetimindeki hatalar sonucu ortaya çıkar. Gruen ve ark.(3) hastaneye ulaştırıl-mış 2594 politravma hastasında mortaliteye katkıda bulunan hata modellerini saptamaya çalışmışlar, hava yolu güvenliğinin sağlanamaması veya korunamamasının mortaliteye ilişkin en yaygın faktör olduğunu bulmuşlardır.Günümüzde, fasiyal travmalar, trafik kazaları, endüstriyel kazalar, silah ve bıçak saldırıları, terör eylemleri ve savaş yaralanmaları nedeniyle oldukça yaygındır (4,5) . Fasiyal yaralanmalar, kafa travması ve hava yolu bütünlüğünde bozulma ile birlikte değilse genellikle yaşamı tehdit etmez. Bu tür hastalarda hava yolu güvenliği ile ilgili başlıca riskler; hastanın hava yolu anatomisinde bulunan kemiklerin parçalanması, yumuşak doku bütünlüğünün bozulması ve aspirasyon pnömonisi insidansının artmasıdır (6) . Travma yönetiminin ABC'lerinin acil serviste yapılmasını sağlamak için ciddi bir fasiyal travma ile uğraşırken multidisipliner yaklaşıma gereksinim duyulmaktadır. Amaç; hava yolu güvenliğinin sağlanması, hastanın solunumunun stabilize edilmesi, kanamanın kontrol edilmesi ve servikal vertebralarda herhangi bir hasar olmadığından emin olmaktır (7) .Supraklavikular bölgede yaralanması olan bir hastada görüntüleme ile aksi ispat edilene kadar servikal vertebra hasarı var olarak kabul edilir (8) . Bilinci yerinde olmayan veya nörolojik defisitli, anormal refleksleri Okmeydanı Tıp Dergisi 33(Ek sayı):

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The Success of Emergency Endotracheal Intubation in Trauma Patients: A 10-Year Experience at a Major Adult Trauma Referral Center

Abstract: In the hands of experienced anesthesiologists, rapid sequence intubation followed by direct laryngoscopy is a remarkably effective approach to emergency airway management. An algorithm designed around this approach can achieve very high levels of success.

Cited by 103 publications

References 21 publications

Simplifying trauma airway management in South African rural hospitals

Simplifying trauma airway management in South African rural hospitals

Surgical airways for trauma patients in an emergency surgical setting: 11 years’ experience at a teaching hospital in Japan

Safely Airway Management in Larinks and Tracheobronchial Injuries

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