A Review of Emergent Inpatient Intubations

In a large, prospective observational study of adult emergent intubations performed outside the operating room by senior anesthesiology residents (an attending anesthesiologist also was present for 33%) at a U.S. academic hospital between 2001 and 2009, researchers assessed rates of difficult intubation, complications, and rescue airway maneuvers. Awake fiber-optic intubations and intubations performed by emergency department (ED) staff without anesthesiology involvement were excluded.

Of 3423 intubations reviewed, 351 (10%) were difficult intubations — defined as Cormack-Lehane grade III or IV laryngoscopic view or three or more attempts. Sixty percent of intubations were performed in the intensive care unit, 39% on the floor, and 1% in the…