Home|Journals|Articles by Year|Audio Abstracts RSS - TOC

SJEMed. 2021; 2(2): 142-146

The importance of the number of tracheal intubation attempts at the Emergency Department of King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia

Elaf Alshammari, Nesrin Alharthy, Suliman Alqueflie, Lama Alasmari.


Background: Tracheal intubation (TI) is an intervention in the Emergency Department (ED) to stabilise children and to protect the airway. The aim of the study was to investigate the prevalence of TI, the number of attempts to achieve successful intubation, the indications and the adverse outcomes related to TI in the paediatric population.
Methods: A quantitative cross-sectional study, using a chart review of the hospital's electronic database, was conducted with paediatric patients who required intubation, from May 2015 to the current date.
Results: A total of 159 paediatric patients' records were analysed. The proportion of a successful first intubation attempt was 87.4% (n = 139), two attempts 6.9% (n = 11), and three or more attempts 5.7% (n = 9). The most frequent indication for TI in the sample was trauma (35.3%, n = 55). In terms of TI-related complications, 22% (n = 35) experienced at least one complication. Of the successful first attempt group, cardiac arrest without return of spontaneous circulation (ROCS) was observed in 12.9% (n = 18). Other TI-related adverse events included hypotension requiring treatment (5.8%, n = 8), emesis (1.4%), bleeding through the tube (2.9%) and secretions via the tube (2.9%). For the two attempts group (n = 11), 18.2% (n = 2) had secretions from the tube and 18.2% experienced bleeding through the tube. For the three or more attempts group, cardiac arrest with ROCS (22.2%, n = 2), and secretions from the tube (22.2%, n = 2), were observed. The majority (96.2%) of the patients had a successful extubation, 8.7% (n = 13) experienced postextubation stridor, 2% (n = 3) became agitated, and 5.3% (n = 8) experienced respiratory distress.
Conclusion: The TI success rate was 87.4%, and adverse outcomes occurred in 22% of all attempts. There is a higher prevalence of TI-related adverse events with multiple attempts to intubate. It is urgent that ED healthcare providers maximise their efforts to achieve success with the first intubation.

Key words: Intubation, tracheal, extubation, trauma.

Full-text options

Share this Article

Online Article Submission
• ejmanager.com

ejPort - eJManager.com
Review(er)s Central
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.