Emergency airway management in geriatric and younger patients: analysis of a multicenter prospective observational study

Imamura, Taichi; Brown, Calvin A.; Ofuchi, Hisashi; Yamagami, Hiroshi; Branch, Joel; Hagiwara, Yusuke; Brown, David F.M.; Hasegawa, Kohei

doi:10.1016/j.ajem.2012.07.008

Cited by 29 publications

(25 citation statements)

References 17 publications

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“…The study setting, methods of measurement, and measured variables were as previously described [6, 9–11]. Briefly, JEAN was initiated in April 2010 as consortium of 13 academic and community medical centers across Japan.…”

Section: Methodsmentioning

confidence: 99%

A comparison of emergency airway management between neuromuscular blockades alone and rapid sequence intubation: an analysis of multicenter prospective study

et al. 2017

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BackgroundAlthough airway management with neuromuscular blockade (NMB) alone is discouraged in the emergency department (ED), our previous study demonstrated that many patients were intubated using NMBs alone without sedatives. To refute this practice, we sought to compare the intubation success and adverse event rates between NMBs only and rapid sequence intubation (RSI).MethodsThis is a secondary analysis of the data from a prospective observational study of ED patients in 13 hospitals who underwent emergency airway management from April 2010 to August 2012. The primary outcome was intubation success rate on first attempt. The secondary outcomes were the intubation success rate in ≤2 attempts and the intubation-related adverse event rate. We compared these outcomes between intubation attempts using NMB alone and RSI. We fit multivariable logistic regression models adjusting for potential confounders (age, sex, weight, primary indication for intubation, and training level of intubators).ResultsOverall, 852 patients were eligible for this analysis, with 114 (13%) intubated with NMB alone and 738 (87%) with RSI. Between the NMB-alone and RSI groups, no significant differences were observed in the success rate on the first attempt (70 vs. 73%; P = 0.48) or in ≤2 attempts (89 vs. 91%; P = 0.46), or in the adverse event rate (11 vs. 12%; P = 0.58). Similarly, after adjusting for confounders, no significant differences were observed in any of these outcomes (all P > 0.05).ConclusionsIn this analysis of data from a large multicenter study of ED patients, we found no superior effectiveness of intubation with NMB alone when compared to RSI. Our data lend significant support to the concept that intubation with NMB alone should be avoided in the ED.

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Section: Methodsmentioning

confidence: 99%

A comparison of emergency airway management between neuromuscular blockades alone and rapid sequence intubation: an analysis of multicenter prospective study

et al. 2017

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“…The study setting, methods of measurement, and measured variables have been reported elsewhere 3 7 10 11. Briefly, JEAN is a consortium of 13 academic and community medical centres from different geographic regions across Japan.…”

Section: Methodsmentioning

confidence: 99%

“…After each intubation encounter in the ED, the intubator completed a standardised data collection form that included the patient's age, sex, primary indication for intubation, methods of intubation, all medications used to facilitate intubation, intubator level of training and specialty, number of attempts, success or failure, and adverse events 3 7 10 11. We monitored compliance with data form completion by reviewing professional billing records.…”

Section: Methodsmentioning

confidence: 99%

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Repeated attempts at tracheal intubation by a single intubator associated with decreased success rates in emergency departments: an analysis of a multicentre prospective observational study

Goto

Watase²,

Morita

et al. 2014

Emerg Med J

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“…A regional, national, or international geriatric ED research consortium could expedite the incorporation of key components into existing and future geriatric EDs. The advantages of establishing a geriatric ED research consortium include ease of access between pertinent stakeholders to assess awareness, 66 practice patterns, 67 and regional variation in outcomes. 68 The ED is a unique laboratory to evaluate underrepresented populations and acute disease phenotypes that may require different approaches to the design and conduct of research.…”

Section: Discussionmentioning

confidence: 99%

A Profile of Acute Care in an Aging America: Snowball Sample Identification and Characterization of United States Geriatric Emergency Departments in 2013

Hogan

Olade

Carpenter

2014

Academic Emergency Medicine

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Background: The aging of America poses a challenge to emergency departments (EDs). Studies show that elderly patients have poor outcomes despite increased testing, prolonged periods of observation, and higher admission rates. In response, emergency medicine (EM) leaders have implemented strategies for improved ED elder care, enhancing expertise, equipment, policies, and protocols. One example is the development of geriatric EDs gaining in popularity nationwide. To the authors' knowledge, this is the first research to systematically identify and qualitatively characterize the existence, locations, and features of geriatric EDs across the United States.

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Emergency airway management in geriatric and younger patients: analysis of a multicenter prospective observational study

Cited by 29 publications

References 17 publications

A comparison of emergency airway management between neuromuscular blockades alone and rapid sequence intubation: an analysis of multicenter prospective study

A comparison of emergency airway management between neuromuscular blockades alone and rapid sequence intubation: an analysis of multicenter prospective study

Repeated attempts at tracheal intubation by a single intubator associated with decreased success rates in emergency departments: an analysis of a multicentre prospective observational study

A Profile of Acute Care in an Aging America: Snowball Sample Identification and Characterization of United States Geriatric Emergency Departments in 2013

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