A prospective Study of Tracheal Intubation and Immediate Complications in Emergency Room in Srinagarind Hospital

Abstract

Background and Objective: Airway management is an important part of the critically ill and injured patients’ management in the emergency room(ER). Numerous studies from developed countries were demonstrated the competency of emergency doctors in intubation. To date there have been no published data on intubations performed in the ER in Srinagarind hospital. The aim of this study is to collect the incidence of intubation related complications and physician who intubated in the ER in Srinagarind hospital.

Methods: Prospective cohort study by 192 patients intubated by the physician team in emergency room during 1 December 2009 - 30 November 2010. Standardized data forms were used to collect detail information on the intubation physician, physician’s department, techniques and complications.

Results:  All of the 192 patients were successfully intubated. A total of 81 (42.2%) intubations were done by doctor from medical physician and trainee. There were 73 patients (38%) reported immediate intubation related complications. The most common complication was traumatic at upper airway soft tissue. The highest incidences of complications were done by anesthesiologists and trainee. Analysis data with Chi-square test at alpha = 0.05 and Fisher's exact test (significant = p <0.05) between groups of the physicians from each department who performed intubation and incidence of immediate complications found no statistically significant. But analysis of all of the physicians who performed intubation and incidence of immediate complications of intubation found a correlation statistically significant (95% Confidence Interval = 38 (31-45), p = 0.03)

Conclusion: Tracheal intubations in emergency room in Srinagarind hospital were performed by rotational doctor from many departments. Medicine doctors and trainee were intubated most of intubation related complications has been found 38%.  Faster specialist consultation and use of an appropriate monitor to confirm the position of the endotracheal tube was recommended for reducing intubation related complications.