| Title | Radiological validation of tracheal tube insertion depth in out-of-hospital and in-hospital emergency patients. | | Author(s) | Geisser W, Maybauer DM, Wolff H, Pfenninger E, Maybauer MO | | Institution | Department of Anaesthesiology, County Clinic at Dillingen, Germany. | | Source | Anaesthesia 2009 Sep; 64(9):973-7. | | MeSH | Adolescent
Adult
Blood Pressure
Bronchi
Child
Child, Preschool
Clinical Competence
Emergencies
Emergency Medical Services
Emergency Service, Hospital
Foreign Bodies
Germany
Heart Rate
Humans
Infant
Intubation, Intratracheal
Medical Errors
Oxygen
Partial Pressure
Retrospective Studies
Tomography, X-Ray Computed
Young Adult
| | Abstract | We performed a 5-year, retrospective study using records of 1081 patients admitted to the trauma emergency room at a University Hospital to investigate the occurrence of tracheal tube malpositioning after emergency intubation in both the inpatient and outpatient settings, using chest radiographs and CT scans in the trauma emergency room. Prehospital patients and inpatients referred from peripheral hospitals were compared. This study showed that tracheal tube misplacements occur with an incidence of 18.2%, of which almost a third (5.7%) were placed in a main bronchus. We further show that tracheal intubation in emergency patients approximates the misplacement rates in the prehospital or in-hospital settings. We speculate that the skill level of the operator may be critical in determining the success of tracheal intubation. Based on our findings, all efforts should be made to verify the tube position with immediate radiographic confirmation after admission to the emergency room. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19686482 |
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