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

Kerslake, Dean; Oglesby, Angela J.; Rollo, Nicola Di; Ed, James; McKeown, Dermot; Ray, David C.

doi:10.1016/j.resuscitation.2015.01.005

Cited by 41 publications

(36 citation statements)

References 23 publications

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“…One of the priorities in critically injured patients in the ED is intubation with the aim to protect the airway, deliver sufficient oxygen, and maintain adequate ventilation. Approximately 10–30% of intubations in the ED were undertaken for patients with trauma, with a first‐pass success rate ranging from 64% to 86% …”

Section: Special Circumstance: Patients With Traumamentioning

confidence: 99%

“…In the ED, up to 40% of intubations were carried out in patients with cardiac arrest . Although the best intubation strategy during cardiopulmonary resuscitation (CPR) has not been established, intubation is considered the definitive method to secure the airway .…”

Section: Special Circumstance: Cardiac Arrestmentioning

confidence: 99%

“…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%

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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: Special Circumstance: Patients With Traumamentioning

confidence: 99%

Section: Special Circumstance: Cardiac Arrestmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

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“…Airway management in the emergency department (ED) frequently requires intubation of the trachea, and typically this is accomplished using a rapid sequence intubation technique . Unfortunately, critically ill patients requiring emergency intubation often have an airway soiled with blood or vomitus, which can potentially make intubation more difficult by obscuring the relevant anatomy during laryngoscopy .…”

mentioning

confidence: 99%

The Impact of a Soiled Airway on Intubation Success in the Emergency Department When Using the GlideScope or the Direct Laryngoscope

Sakles

Corn

Hollinger

et al. 2017

Academic Emergency Medicine

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“…According to the Park et al study, the effectiveness of the first intubation attempt in the emergency department is 84.1% for all patients and 81.8% for trauma patients [22]. These results are also confirmed by the study by Kerslake et al, where the effectiveness of the first intubation attempt by emergency physicians and anaesthetists was 85% [23]. In emergency medicine, due to progressive hypoxia and the necessity to perform other medical procedures, it is essential to perform endotracheal intubation in the shortest possible time and in relatively few attempts.…”

Section: Discussionmentioning

confidence: 66%

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

Karczewska

Smereka

Dąbrowski

et al. 2020

Disaster Emerg Med J

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InTRoDuCTIon:Endotracheal intubation is one of the basic procedures performed in emergency medicine in patients with respiratory insufficiency, inability to maintain airway patency, or apnoea. Rapid performance of the procedure and implementation of ventilation are among the basic principles of rescue procedures. The primary aim of the present systematic review and meta-analysis was to compare the VivaSight single lumen (SL) tube-mounted camera with a standard endotracheal single-lumen tube and direct laryngoscope for endotracheal intubation based on randomised controlled trials of simulation or cadaver trials. The analysis was based on the hypothesis that the use of videolaryngoscopy based on VivaSight SL tube increases the effectiveness of endotracheal intubation, reducing the risk of ineffectiveness of the first intubation attempt and the risk of adverse events, such as dental compression. MATeRIAL AnD MeThoDS:We searched the MEDLINE, EMBASE, Scopus, Cochrane, and Google Scholar databases for randomised, controlled trials and observational studies from 1985 until October 2019, without language restrictions. Grey literature, clinicaltrials.gov, and reference lists of articles were hand searched. We conducted a meta-analysis with random-effects models to evaluate time to intubation, first-pass success rates, overall success rates, dental compression, and glottic view. ReSuLTS:The search located 12 eligible studies. The time of intubation using VivaSight was significantly shorter than that of direct laryngoscopy (MD = -11.29 [-13.10, -9.49], p < 0.001). The efficacy of the first intubation attempt was higher for VivaSight than for double lumen (DL) (96.0% vs. 61.7%; RR = 1.62 [1.40, 1.88], p < 0.001). The meta-analysis showed that the total efficacy of VivaSight intubation compared to direct laryngoscopy was statistically significantly higher (100% vs. 88.9%, RR = 1.11 [1.02, 1.20]; p = 0.02). The glottis visibility assessed as Cormack-Lehane grade I or II was better in VivaSight intubation compared to direct laryngoscopy (100% vs. 90.9%, RR = 1.05 [0.99, 1.12]; p = 0.08). ConCLuSIonS:Our meta-analysis suggests that the VivaSight SL provided better glottic visualisation and shorter intubation time, with improved success rates during different simulated intubation scenarios.

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

Cited by 41 publications

References 23 publications

Advancing emergency airway management practice and research

Advancing emergency airway management practice and research

The Impact of a Soiled Airway on Intubation Success in the Emergency Department When Using the GlideScope or the Direct Laryngoscope

VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials

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