Adult ; Aged ; Clinical Competence* ; Emergency Service, Hospital/statistics & numerical data* ; Female ; Humans ; Hypnotics and Sedatives/therapeutic use ; Internet ; Intubation, Intratracheal/adverse effects ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/methods* ; Intubation, Intratracheal/statistics & numerical data* ; Laryngoscopes ; Laryngoscopy/methods* ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Prospective Studies ; Registries ; Republic of Korea ; Video-Assisted Surgery
Keywords
airway ; emergency ; trauma
Abstract
BACKGROUND: The investigators developed a Web-based online registration system to identify the current status of trauma airway management.
OBJECTIVES: The purpose of the study was to identify first-pass success (FPS) rate of the intubation methods and devices that are currently used, as well as the factors that affect FPS in trauma patients.
METHODS: This study was designed as a prospective, observational multi-center study. We obtained clinical data of intubated trauma patients in 13 academic emergency departments in Korea. After performing an intubation, each patient's data were entered into a Web-based registry. Logistic regression analyses were conducted to identify the factors that affect FPS.
RESULTS: The FPS rate was 80.6% in all trauma patients. The curved-blade laryngoscope was the most commonly used instrument, and was applied to 1395 patients (76.2%) during first attempt. Video laryngoscopy was applied to 341 patients (18.6%). In the multivariate logistic regression analysis, factors that affected FPS in difficult airway trauma patients were emergency physicians, senior physicians, and video laryngoscopy (odds ratio 2.42, 95% confidence interval 1.04-5.65; 1.80, 1.16-2.79; and 2.16, 1.39-3.33, respectively).
CONCLUSIONS: Emergency physicians in Korea are prepared for trauma patient airway management. The backup by experienced senior physicians, and preparation and training for video laryngoscope could assist FPS for trauma patients.