Article Figures & Data
Tables
- Table 1
Patient demographics, injury severity, physiological variables, intubating operator level of training, periprocedural oxygenation, neuromuscular blocking agent, and device used for laryngoscopy
First pass success without hypoxemia n=167 No first pass success without hypoxemia n=79 Difference (95% CI) P value Age (mean) 36 44 −8 (−3.3 to −12.7) 0.001 ISS (mean) 34 31 −2.9 (−7.8 to 2.2) 0.25 GCS (mean) 10 9.3 −0.7 (−1.9 to 0.5) 0.25 GCS, median (IQR) 11 (6, 14) 9 (6, 13.5) GCS score 13–15 (n) 73 (43.7%) 23 (29.1%) 14.6% (2.1 to 27.1) 0.03 Heart rate (mean) 100 93 −6.7 (−13.9 to 0.4) 0.06 Systolic BP (mean) 133 131 −2.0 (−10.7 to 6.7) 0.65 Respiratory rate (mean) 21 21 0.05 (−2.0 to 2.0) 0.99 Head or facial injury (n) 76 (46%) 32 (40%) 5.0% (−8.2 to 18.2) 0.38 Penetrating injury (n) 48 (28.7%) 15 (18.9%) 9.8% (−2.0 to 20) 0.10 Operator training level (n) Attending 45 (27%) 19 (24%) 3% (−9.1 to 13.8) 0.62 EM PGY 4 16 (10%) 4 (5%) 5% (−3.1 to 11.2) 0.19 EM PGY 3 29 (17%) 18 (23%) −5.4% (−16.3 to 5.5) 0.26 EM PGY 2 49 (29%) 20 (25%) 4.0% (−7.8 to 15.8) 0.51 EM PGY 1 28 (17%) 18 (23%) −6.0% (−17.5 to 4.1) 0.26 Oxygen saturation O2 pre-RSI (mean) 97% 97% −0% (−2 to 2) 0.99 Hypoxemia at confirmation (n) 0 (0%) 59 (75%) 75% (65 to 84) <0.0001 O2 at time of confirmation (mean) 96% 85% −11% (−12 to −8.3) <0.0001 Laryngoscopic device (n) Direct 159 (95%) 77 (97%) −2.3% (−7 to 2.5) 0.47 Video 8 (5%) 2 (2.5%) 2.3% (−2.5 to 7) 0.36 NMBA (n) Succinylcholine 121 (72.5%) 44 (55.7%) 16.8% (4.1 to 29.4) 0.01 Rocuronium 46 (27.5%) 35 (44.3%) −16.8% (−4.1 to −29.4) 0.01 O2=SpO2. Hypoxemia=SpO2<90%. O2 pre-RSI=most recent SpO2 obtained before the RSI medications were administered. O2 at time of confirmation=the lowest SpO2 after induction and within 2 min after confirmation of intubation.
BP, blood pressure; EM, emergency medicine; GCS, Glasgow Coma Scale; ISS, Injury Severity Score; NMBA, neuromuscular blocking agent; RSI, rapid sequence intubation.
- Table 2
Multivariate logistic regression analysis for first pass success without hypoxemia among trauma patients requiring emergent tracheal intubation
Adjusted OR 95% CI P value NMBA Rocuronium Reference Succinylcholine 2.1 1.2 to 3.8 0.014 Hypoxia No hypoxemia prior to RSI Reference Hypoxemia prior to RSI 1.7 0.5 to 6.1 0.395 GCS score 3–12 Reference 13–15 1.8 1.0 to 3.3 0.049 Head or facial injury No head or facial injury Reference Head or facial injury 1.3 0.7 to 2.2 0.445 Level of training PGY 1–2 Reference PGY 3 or greater 1.1 0.6 to 1.8 0.867 Hypoxemia=SpO2< 90%. Hypoxemia prior to RSI=most recent SpO2 obtained before the RSI medications were administered.
GCS, Glasgow Coma Scale; NMBA, neuromuscular blocking agent; RSI, rapid sequence intubation.
