Adverse Events Much More Likely with Repeated Intubation Attempts

The incidence of adverse events tripled when a second attempt was needed.

To determine the association between adverse events and number of endotracheal intubation attempts, researchers reviewed standardized data collected from 1828 orotracheal intubations performed at an academic emergency department during 4 years. Almost all of the intubations (98%) were by performed by trainees, mostly second- and third-year emergency medicine residents. Adverse events were defined as accidental extubation, aspiration, cardiac arrest, cuff leak, dental trauma, dysrhythmia, esophageal intubation, hypotension (decrease in systolic blood pressure <90 mm Hg), laryngospasm, mainstem intubation, oxygen desaturation (decrease in oxygen saturation ≥10%), and pneumothorax.

Intubation was successful on the first attempt in 73% cases and…

Reviewing Author

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)

Diane M. Birnbaumer, MD, FACEP

Disclosures

Consultant / Advisory boardSecurisyn

Editorial boardsThe Merck Manuals (Home and Physician Editions)