The Success Rate of Endotracheal Intubation in the Emergency Department of Tertiary Care Hospital in Ethiopia, One-Year Retrospective Study

Abstract

Background. Emergency medical care starts with airway assessment and intervention management. Endotracheal intubation is the definitive airway management in the emergency department (ED) for patients requiring a definitive airway. Successful first pass is recommended as the main objective of emergency intubation. There exists no published research regarding the success rates or complications that occur within Ethiopian hospitals emergency department intubation practice. Objective. This study aimed to assess the success rate of emergency intubations in a tertiary hospital, Addis Ababa, Ethiopia. Methodology. This was a single institute retrospective documentation review on intubated patients from November 2017 to November 2018 in the emergency department of Addis Ababa Burn Emergency and Trauma Hospital. All intubations during the study period were included. Data were collected by trained data collectors from an intubation documentation sheet. Result. Of 15,933 patients seen in the department, 256 (1.6%) patients were intubated. Of these, 194 (74.9%) were male, 123 (47.5%) sustained trauma, 65 (25.1%) were medical cases, and 13(5%) had poisoning. The primary indications for intubation were for airway protection (160 (61.8%)), followed by respiratory failure (72(27.8%)). One hundred and twenty-nine (49.8%) had sedative-only intubation, 110 (42.5%) had rapid sequence intubation, and 16 (6.2%) had intubation without medication. The first-pass success rate in this sample was 70.3% (180/256), second-pass 21.4% (55/256), and third-pass 7.4% (19/256), while the overall success rate was 99.2% (254/256). Hypoxia was the most common complication. Conclusion. The intubation first-pass success rate was lower than existing studies, but the overall intubation success rate was satisfactory.

Tracheal Intubation in Emergency Departments in China: A National Cross-Sectional Survey

“…Our results showed that 85.7% of patients were intubated successfully on the first attempt. This rate compares favorably to ED intubations in other countries, which range from 70.3 to 85% in several studies (2,(22)(23)(24). Unsurprisingly, physicians with greater intubation experience were associated with a higher intubation success rate.…”

Emergency airway management in resource limited setting

“…M Wongyingsinn et al at Siriraj Hospital revealed that 7 people received endotracheal intubation over a year [ 27 ]. Notably, 79.5% of these intubations were effective on the first try, making 99.6% successful [ 11 ].…”

Practice and Outcomes of Endotracheal Intubation in the Emergency Department : a retrospective observational study at a single institution in Bhutan

“…However multiple studies have shown ketamine as safe alternative. (12,13,17) The choice of induction drugs depends on the intubating physicians,\ their familiarity with the drug and clinical factors such as comorbidities and vital signs at the time of intubation such as avoiding propofol and midazolam in hypotension. (10,13,17) Paralytic agents minimize complications and improve chance of rst pass success during RSI.…”