Journal article
Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study
Telemedicine journal and e-health, Vol.23(4), pp.29-297
04/01/2017
DOI: 10.1089/tmj.2016.0140
PMID: 27673565
Abstract
Background:
Intubation in rural emergency departments (EDs) is a high-risk procedure, often with little or no specialty support. Rural EDs are utilizing real-time telemedicine links, connecting providers to an ED physician who may provide clinical guidance.
Introduction:
We endeavored to describe telemedicine-assisted intubation in rural EDs that are served by an ED telemedicine network.
Materials and Methods:
Prospective data were collected on all patients who had an intubation attempt while on the video telemedicine link from May 1, 2014 to April 30, 2015. We report demographic information, indication, methods, number of attempts, operator characteristics, telemedicine involvement/intervention, adverse events, and clinical outcome by using descriptive statistics.
Results:
Included were 206 intubations. The most common indication for intubation was respiratory failure. First-pass success rate (postactivation) was 71%, and 96% were eventually intubated. Most attempts (66%) used rapid-sequence intubation. Fifty-four percent of first attempts used video laryngoscopy (VL). Telemedicine providers intervened in 24%, 43%, and 55% of first–third attempts, respectively. First-pass success with VL and direct laryngoscopy was equivalent (70% vs. 71%, p = 0.802). Adverse events were reported in 49 cases (24%), which were most frequently hypoxemia.
Discussion:
The impact of telemedicine during emergency intubation is not defined. We showed a 71% first-pass rate post-telemedicine linkage (70% of cases had a previous attempt). Our ultimate success rate was 96%, similar to that in large-center studies. Telemedicine support may contribute to success.
Conclusions:
Telemedicine-supported endotracheal intubation performed in rural hospitals is feasible, with good success rates. Future research is required to better define the impact of telemedicine providers on emergency airway management.
Details
- Title: Subtitle
- Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study
- Creators
- Lucas Van Oeveren - 2Avera eCARE, Avera Health System, Sioux Falls, South DakotaJulie Donner - 2Avera eCARE, Avera Health System, Sioux Falls, South DakotaAndrea Fantegrossi - 3Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MassachusettsNicholas M Mohr - 5Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IowaCalvin A Brown - 6Harvard Medical School, Boston, Massachusetts
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.23(4), pp.29-297
- DOI
- 10.1089/tmj.2016.0140
- PMID
- 27673565
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- Mary Ann Liebert, Inc
- Language
- English
- Date published
- 04/01/2017
- Academic Unit
- Rural Telehealth Research Center; Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984024536702771
Metrics
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