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Indian Journal of Emergency Medicine

Volume  9, Issue 3, July-September 2023, Pages 57-63
 

Original Article

Outcome of Emergency Endotracheal Intubation in Critically Ill Adults in General ward, Critical Care Unit and Triage: A Comparative Study

Omprakash Sundrani, Pratiksha Agrawal, Pratibha Jain Shah, Heeramani Lodhi

1Professor & HOD, Department of Critical Care Medicine, 2Associate Professor, 3Professor & HOD, 4Resident, Department of Anesthesia and Pain Management, Pt. Jawaharlal Nehru Memorial Medical College, Raipur 492001, Chhattisgarh, India.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.9323.1

Abstract

Background & Aims: Emergency endotracheal intubation is a life-saving procedure in any setting. We compared the outcomes of emergency endotracheal intubation calls for Anesthesiologists in General ward, Critical care unit and Triage in a single medical centre.

Settings and Design: Prospective, Cross sectional study.

Methods and Material: We evaluated all patients admitted to the Ward, Critical care unit and Triage between October 2021 to November 2022. A total of 186 patients, >18 years of age, who required emergency endotracheal intubation were included in this study. Primary outcome was to estimate the proportion of difficult & failed endotracheal in tubation. Secondary outcome was to assess the incidence of complications, survival and neurological outcome.

Results: General ward had the highest proportion of difficult intubations (67.74%), followed by Triage (62.9%), and CCU (61.29%). General ward had 4.83% failed intubation followed by Triage 1.61%. The incidence of hypoxemia (33.87%) and hemodynamic collapse (12.9%) was higher in General ward as compared to CCU (12.9% & 9.68%) and Triage (24.19% &11.2%), (P=0.02 & 0.04 respectively). There was a trend of higher survival rate in CCU (67.74%) as compared to General ward (25.61%) & Triage (51.61%). Among these locations, CCU had the highest rate of neurologically intact (53.23%) survival to hospital discharge as compared to General ward (16.13%) & Triage (30.63%). Conclusions: We concluded that the proportion of difficult and failed intubation, was highest in General ward followed by Triage and CCU. Incidence of complications was least in CCU followed by Triage and General ward.


Keywords : Endotracheal Intubation; CCU; Triage; Difficult and Failed Intubation.
Corresponding Author : Omprakash Sundrani, Professor & HOD, Department of Critical Care Medicine, Pt. Jawaharlal Nehru Memorial Medical College, Raipur 492001, Chhattisgarh, India.