Table 2 Intubation performance (n = 336)
Number of patients (N = 336) | Percentage (%) | |
|---|---|---|
Indication for Intubation | ||
Acute respiratory failure | 254 | (75.6%) |
Need for intubation to perform an urgent or elective procedure outside of the OR | 36 | (10.7%) |
Airway protection | 24 | (7.1%) |
Self extubation | 19 | (5.7%) |
Endotracheal tube exchange | 3 | (0.9%) |
Location | ||
ICU | 196 | (58%) |
Non ICU (ward, remote location, trauma room) | 140 | (42%) |
Timing of events | ||
6:00 AM - 6:00 PM | 193 | (57.4%) |
6:00 PM - 6:00 AM | 139 | (41.4%) |
Attending Present | 13 | (3.9%) |
Oxygenation (upon arrival to scene) | ||
Non rebreather face mask | 118 | (35.1%) |
Nasal cannula | 87 | (25.9%) |
Bag mask ventilation | 50 | (14.9%) |
BIPAP (Bilevel Positive Airway Pressure) | 42 | (12.5%) |
Room air | 14 | (4.2%) |
CPAP (Continuous Positive Airway Pressure) | 3 | (0.9%) |
Face tent | 1 | (0.3%) |
Patient was already Intubated | 1 | (0.3%) |
Not documented | 20 | (6%) |
Induction | ||
Standard intravenous induction | 131 | (39.0%) |
RSI (rapid sequence induction) | 176 | (52.4%) |
Ventilation (after induction) | ||
Easy ventilation | 162 | (48.2%) |
Easy with airway adjunct | 55 | (16.4%) |
Moderate difficult with airway adjunct | 10 | (3.0%) |
Difficult | 4 | (1.2%) |
Two person ventilation | 24 | (7.1%) |
Unable to ventilate | 2 | (0.6%) |
Not indicated | 91 | (27.1%) |
Cricoid Pressure applied | 170 | (50.6%) |
Cricoid Pressure not applied | 159 | (47.3%) |
Medication | ||
Etomidate | 281 | (83.6%) |
Propofol | 24 | (7.1%) |
Ketamine | 1 | (0.3%) |
No sedation medication for induction | 31 | (9.2%) |
Rocuronium | 277 | (82.4%) |
Succinylcholine | 28 | (8.3%) |
No muscle relaxant for induction | 28 | (8.3%) |
Phenylephrine | 40 | (11.9%) |
Ephedrine | 4 | (1.2%) |
Other | 5 | (1.5%) |
Intubation device | ||
Mac blade | 236 | (70.2%) |
MAC 3 | 86 | (36.4%) |
MAC 4 | 144 | (61.0%) |
Not reported | 6 | (2.5%) |
Miller | 0 | (0%) |
Video laryngoscope | 92 | (27.4%) |
Glidescope® blade 3 | 63 | (68.5%) |
Glidescope® blade 4 | 25 | (27.2%) |
Not reported | 4 | (4.3%) |
Laryngeal Mask Airway (LMA) | 1 | (0.3%) |
Awake fiberoptic | 5 | (1.5%) |
Surgical Airway | 2 | (0.6%) |
Bougie | 2 | (0.6%) |
Intubation Grade (Cormack-Lehane Grading) | ||
Grade 1. Full view of glottis | 252 | (75.0%) |
Grade 2. Partial view of glottis | 56 | (16.7%) |
Grade 3. Only epiglottis seen, none of glottis seen | 20 | (6.0%) |
Grade 4. Neither glottis nor epiglottis seen | 5 | (1.5%) |
Intubation attempt | ||
Attempts 1 | 296 | (88.1%) |
Attempts 2 | 31 | (9.2%) |
Attempts 3 | 7 | (2.1%) |
Attempts > 3 | 0 | (0%) |
Difficulty (Intubation Difficulty Scale) | ||
Easy | 290 | (86.3%) |
Mod difficult | 35 | (10.4%) |
Difficult | 6 | (1.8%) |
Impossible | 1 | (0.3%) |
Attempt aborted | 0 | (0%) |
Intubation achieved | 333 | (99.1%) |
ETT size (mm) | ||
5 | 1 | (0.3%) |
5.5 | 0 | (0%) |
6 | 1 | (0.3%) |
6.5 | 4 | (1.2%) |
7 | 48 | (14.3%) |
7.5 | 184 | (54.8) |
8 | 88 | (26.2) |
8.5 | 1 | (0.3%) |
Unknown | 9 | (2.7%) |