Morbid Obesity Is Associated with Difficult Prehospital Tracheal Intubation

The likelihood of difficult intubation was nearly four times higher in patients with a body-mass index ≥40 kg/m² than in nonobese patients.

Obesity is associated with difficult tracheal intubation in patients undergoing elective anesthesia. To determine whether this association exists also for patients undergoing emergency intubation in the prehospital setting, researchers reviewed prospectively collected registry data for 823 prehospital intubations performed by advanced life support providers (paramedics) with specialized training in airway management during a 4-year period in Seattle.

Body-mass index (BMI) was <30 kg/m² in 653 patients, 30–39 kg/m² in 146 patients, and ≥40 kg/m² in 24 patients. Overall, intubation was successful in 811 patients (98.5%), and success rates did not vary significantly among weight groups. Fifty-six patients (6.8%) met the study definition of “dif…

Reviewing Authors

Emily L. Brown, MD

Ron M. Walls, MD, FRCPC, FAAEM

Disclosures

Speaker's bureauAirway Management Education Center, LLC

EquityAirway Management Education Center, LLC

Grant / Research supportAgency for Health Care Research and Quality

Editorial boardsManual of Emergency Airway Management; Rosen's Emergency Medicine; UpToDate; Scientific American Medicine