Endotracheal Intubation in the Emergency Department of Lampang and Phrae Hospital

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Skol Hedegaard


Background : Endotracheal intubation is the gold standard for emergency airway management. It composes of 3 techniques; awake, sedate only and rapid sequence intubation (RSI). There is no previous study about intubation in the emergency department of Lampang and Phrae Hospital. 
Objective: To study the indications, diagnoses, methods and results of intubation in patients requiring emergency airway management.
Material and method: In this prospective observational study, data obtained from 253 patients requiring endotracheal intubation in emergency department of Lampang and Phrae Hospital during March to June 2012 included patient’s demographics, indications, diagnoses, intubation techniques, duration, success rate and complications. Comparison among 3 intubation techniques was statistically analyzed.
Results: The mean age was 60.1 ± 19.5 years (range, 0.4-100). 57.3% were male and 152 cases intubated in Lampang Hospital. All of them underwent orotracheal intubation and 83.0% were medical patients. The most common indication was opening and protecting the airway (46.6%). Sedate alone was most commonly used (49.8%), followed by awake intubation (28.1%) and RSI (22.1%). RSI was preferred by emergency physicians (p<0.001). Awake intubation and sedate alone were preferred by general practitioners (p<0.001) and medical students (p=0.010) respectively. The mean intubation time of RSI and awake techniques were 110.2 and 120.4 seconds, shorter than sedate alone (231.0 seconds, p=0.071). The major complications were prolonged intubation (28.4%) and oxygen desaturation (13.8%). Sedate alone had significantly higher incidence of prolonged intubation (p=0.018) and oxygen desaturation (p=0.024). The highest success rate in first attempt belonged to RSI (78.6%), followed by awake intubation
(70.4%) and sedate alone (55.6%).
Conclusion: Sedate alone intubation was the most common technique used in the emergency department of Lampang and Phrae Hospital, followed by awake intubation. RSI was the fastest method and yielded significantly least complications. Prolonged intubation was the most common adverse events and could be minimized by RSI training program.


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Hedegaard, S. . (2022). Endotracheal Intubation in the Emergency Department of Lampang and Phrae Hospital. Lampang Medical Journal, 33(2), 103–114. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/259465
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