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A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study.
US Army Med Dep J 2017 Oct-Dec; (3-17):98-104UA

Abstract

Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period.

MATERIAL AND METHODS

Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017.

RESULTS

During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%).

CONCLUSION

In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success.

Authors+Show Affiliations

Department of Emergency Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29214627

Citation

April, Michael D., et al. "A 12-month Descriptive Analysis of Emergency Intubations at Brooke Army Medical Center: a National Emergency Airway Registry Study." U.S. Army Medical Department Journal, 2017, pp. 98-104.
April MD, Schauer SG, Brown Rd CA, et al. A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study. US Army Med Dep J. 2017.
April, M. D., Schauer, S. G., Brown Rd, C. A., Ng, P. C., Fernandez, J., Fantegrossi, A. E., ... Antonacci, M. (2017). A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study. U.S. Army Medical Department Journal, (3-17), pp. 98-104.
April MD, et al. A 12-month Descriptive Analysis of Emergency Intubations at Brooke Army Medical Center: a National Emergency Airway Registry Study. US Army Med Dep J. 2017;(3-17)98-104. PubMed PMID: 29214627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 12-month descriptive analysis of emergency intubations at Brooke Army Medical Center: a National Emergency Airway Registry study. AU - April,Michael D, AU - Schauer,Steven G, AU - Brown Rd,Calvin A, AU - Ng,Patrick C, AU - Fernandez,Jessie, AU - Fantegrossi,Andrea E, AU - Maddry,Joseph K, AU - Summers,Shane, AU - Sessions,Daniel J, AU - Barnwell,Robert M, AU - Antonacci,Mark, PY - 2017/12/8/entrez PY - 2017/12/8/pubmed PY - 2018/6/21/medline SP - 98 EP - 104 JF - U.S. Army Medical Department journal JO - US Army Med Dep J IS - 3-17 N2 - : Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition. We cross-referenced these forms against the numbers of intubation events reported in the ED nursing daily reports to ensure capture of all intubations. Providers completed forms for every intubation within 6 weeks of the procedure. We analyzed data from March 28, 2016, to March 27, 2017. RESULTS: During the study period, providers performed 259 intubations in the BAMC ED. Reasons for intubation were related to trauma for 184 patients (71.0%) and medical conditions for 75 patients (29.0%). Overall, first-attempt success was 83.0%. Emergency medicine residents performed a majority of first attempts (95.0%). Most common devices chosen on first attempt were a video laryngoscope for 143 patients (55.2%) and a direct laryngoscope for 115 patients (44.4%). One patient underwent cricothyrotomy. The 2 most common induction agents were ketamine (59.8%; 95% CI, 55.2%-67.4%) and etomidate (19.3%; 95% CI, 14.7%-24.7%). The most common neuromuscular blocking agents were rocuronium (62.9%; 95% CI, 56.7%-68.8%) and succinylcholine (18.9%; 95% CI, 14.3%-24.2%). CONCLUSION: In the BAMC ED, emergency intubation most commonly occurred for trauma indications using video laryngoscopy with a high first-pass success. SN - 1946-1968 UR - https://www.unboundmedicine.com/medline/citation/29214627/A_12_month_descriptive_analysis_of_emergency_intubations_at_Brooke_Army_Medical_Center:_a_National_Emergency_Airway_Registry_study_ DB - PRIME DP - Unbound Medicine ER -