• J Trauma · Oct 2007

    Trauma intubations: can a protocol-driven approach be successful?

    • Zoe C Casey, Alan J Smally, Robert J Grant, and Jacqueline McQuay.
    • Emergency Department, Connecticut Children's Medical Center, Hartford Hospital, Hartford, Connecticut, USA. zcasey@ccmckids.org
    • J Trauma. 2007 Oct 1;63(4):955-60.

    ObjectiveTo determine the success rate of a trauma airway protocol.MethodsThis was a prospective cohort study of trauma patients requiring intubation conducted for 24 months. The study facility is a Level I trauma center serving an urban population. The protocol suggests that the first two attempts at intubation be by the third-year emergency medicine resident, a hospital-wide stat overhead page for anesthesia occurs, which results in anesthesia (occasionally a resident only, but usually an attending) presence in the trauma room in 5 to 10 minutes. After each intubation, the emergency medicine resident or the attending physician completed a data collection form indicating the number of intubation attempts and result of each one, who performed each attempt, complications related to each attempt, and airway adjuncts used.ResultsTwo hundred seventy-four patients were intubated during the study period by either emergency medicine physician or anesthesiologist with a success rate of 91.6% after the third attempt. The complication and cricothyrotomy rates were 9.8% and 2.6%, respectively.ConclusionOur trauma airway protocol allows for the safe and effective management of the trauma airway.

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