Journal article
Endotracheal Intubation Strategy, Success, and Adverse Events Among Emergency Department Patients During the COVID-19 Pandemic
Annals of emergency medicine : journal of the American College of Emergency Physicians, Vol.81(2), pp.145-157
02/2023
DOI: 10.1016/j.annemergmed.2022.09.013
PMCID: PMC9633323
PMID: 36336542
Abstract
STUDY OBJECTIVE To describe endotracheal intubation practices in emergency departments by staff intubating patients early in the coronavirus disease 2019 (COVID-19) pandemic. METHODS Multicenter prospective cohort study of endotracheal intubations conducted at 20 US academic emergency departments from May to December 2020, stratified by known or suspected COVID-19 status. We used multivariable regression to measure the association between intubation strategy, COVID-19 known or suspected status, first-pass success, and adverse events. RESULTS There were 3,435 unique emergency department endotracheal intubations by 586 participating physicians or advanced practice providers; 565 (18%) patients were known or suspected of having COVID-19 at the time of endotracheal intubation. Compared with patients not known or suspected of COVID-19, endotracheal intubations of patients with known or suspected COVID-19 were more often performed using video laryngoscopy (88% versus 82%, difference 6.3%; 95% confidence interval [CI], 3.0% to 9.6%) and passive nasal oxygenation (44% versus 39%, difference 5.1%; 95% CI, 0.9% to 9.3%). First-pass success was not different between those who were and were not known or suspected of COVID-19 (87% versus 86%, difference 0.6%; 95% CI, -2.4% to 3.6%). Adjusting for patient characteristics and procedure factors in those with low anticipated airway difficulty (n=2,374), adverse events (most commonly hypoxia) occurred more frequently in patients with known or suspected COVID-19 (35% versus 19%, adjusted odds ratio 2.4; 95% CI, 1.7 to 3.3). CONCLUSION Compared with patients not known or suspected of COVID-19, endotracheal intubation of those confirmed or suspected to have COVID-19 was associated with a similar first-pass intubation success rate but higher risk-adjusted adverse events.
Details
- Title: Subtitle
- Endotracheal Intubation Strategy, Success, and Adverse Events Among Emergency Department Patients During the COVID-19 Pandemic
- Creators
- Nicholas M Mohr - University of IowaEliezer Santos LeonJestin N CarlsonBrian DriverAnusha KrishnadasanKarisa K HarlandPatrick Ten EyckWilliam R MowerTyler M FoleyKelli WallaceL Clifford McDonaldPreeta K KuttyScott SantibanezDavid A Talan
- Resource Type
- Journal article
- Publication Details
- Annals of emergency medicine : journal of the American College of Emergency Physicians, Vol.81(2), pp.145-157
- DOI
- 10.1016/j.annemergmed.2022.09.013
- PMID
- 36336542
- PMCID
- PMC9633323
- NLM abbreviation
- Ann Emerg Med
- ISSN
- 0196-0644
- eISSN
- 1097-6760
- Language
- English
- Electronic publication date
- 11/03/2022
- Date published
- 02/2023
- Academic Unit
- Epidemiology; Emergency Medicine; Biostatistics; Surgery; Anesthesia; Injury Prevention Research Center; Law Faculty; Internal Medicine
- Record Identifier
- 9984313060302771
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