Cheryl Lynn Horton, MD

Hypoxia occurred in 15% of patients and poor glottic view was the only predictor.

To determine the incidence of peri-intubation complications in a physician-staffed Scottish aeromedical transport system, researchers retrospectively analyzed emergent rapid-sequence intubations performed between 2008 and 2012.

Of 208 intubations, 75% were performed during interfacility transport and 25% were performed at the scene of the incident. Peri-intubation desaturation (defined as a drop in oxygen saturation below 90% or a 10% drop from the initial oxygen saturation) occurred in 15.4% of patients. Peri-intubation hypotension (defined as a drop in systolic blood pressure below 90 mm Hg) occurred in 7.9% of patients. On multivariate analysis, a Cormack and Lehane grade 3 or 4 glottic view was the only predictor of oxygen desaturation. Complication rates were similar between emergency medicine–trained and anesthesia-trained physicians.

Citation(s):

Wimalasena YH et al. Comparison of factors associated with desaturation in prehospital emergency anaesthesia in primary and secondary retrievals. Emerg Med J 2014 Nov 12; [e-pub ahead of print].