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Paediatric intubation in Australasian emergency departments : A report from the ANZEDAR
Ghedina, Nicole Alkhouri, Hatem Badge, Helen Fogg, Toby McCarthy, Sally
Ghedina, Nicole
Alkhouri, Hatem
Badge, Helen
Fogg, Toby
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.
Keywords
airway management, emergency medicine, child, intubation
Date
2020
Type
Journal article
Journal
Emergency Medicine Australasia
Book
Volume
32
Issue
3
Page Range
401-408
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled