Paediatric intubation in Australasian emergency departments : A report from the ANZEDAR

Journal article


Ghedina, Nicole, Alkhouri, Hatem, Badge, Helen, Fogg, Toby and McCarthy, Sally. (2020). Paediatric intubation in Australasian emergency departments : A report from the ANZEDAR. Emergency Medicine Australasia. 32(3), pp. 401-408. https://doi.org/10.1111/1742-6723.13416
AuthorsGhedina, Nicole, Alkhouri, Hatem, Badge, Helen, Fogg, Toby and McCarthy, Sally
Abstract

Objectives
To describe the epidemiology, clinical practice and outcomes of paediatric ED intubation in Australia and New Zealand.

Method
Prospectively collected airway management audit data from 43 EDs in Australia and New Zealand that was submitted to the Australia and New Zealand Emergency Department Airway Registry between 2010 and 2015.

Results
Paediatric cases accounted for 4.94% (270/5463) of cases (median age = 3, interquartile range [IQR] = 2–9). A median of 5 (IQR = 2–9) intubations were reported per department per year. Most intubations were performed for medical indications (72.2%), including seizure (25.2%) and respiratory failure (15.2%). Patients were physiologically compromised prior to intubation with 69.5% comatose, 50.9% outside of the normal age-adjusted range for respiratory rate, 15.9% hypoxic and 12.6% hypotensive. Complication rate was 33.3% and desaturation was the most common (18.5%). The ED mortality rate was 3.8%. First pass success (FPS) was 80% (95% CI 75.2–84.8). Infants less than 1 year of age had lower FPS, higher rates of difficult laryngoscopy and higher rates of desaturation than other age groups.

Conclusion
Paediatric intubation in Australasian EDs is rare from a departmental and individual provider viewpoint. Success rates are similar to contemporary international registries. Complications are common and ongoing collaborative multicentre audit with resultant quality improvement is desirable to facilitate improved success and reduced complications.

Keywordsairway management; emergency medicine; child; intubation
Year2020
JournalEmergency Medicine Australasia
Journal citation32 (3), pp. 401-408
PublisherBlackwell Publishing
ISSN1742-6731
Digital Object Identifier (DOI)https://doi.org/10.1111/1742-6723.13416
Scopus EID2-s2.0-85076187131
Research or scholarlyResearch
Page range401-408
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online03 Dec 2019
Publication process dates
Accepted18 Oct 2019
Deposited03 Sep 2021
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