• Lakshmi Gangadharan, C Sreekanth, and Mabel C Vasnaik.
• Department of Emergency Medicine, St. Johns' Medical College and Hospital, Bangalore, India.
• J Emerg Trauma Shock. 2011 Jan 1;4(1):42-7.

BackgroundEndotracheal intubations performed in the Emergency Department.AimsTo assess whether conventional indicators of difficult airway can predict a difficult intubation in the Emergency Setting and to investigate the effect of rapid sequence intubation (RSI) on ease of intubation.Settings And DesignA prospective randomized study was designed involving 60 patients requiring intubation, over a period of 4 months.Materials And MethodsDemographic profile, details of methods used, airway assessment, ease of intubation, and Cormack and Lehane score were recorded. Airway assessment score and ease of intubation criteria were devised and assessed.Statistical AnalysisDescriptive statistical analysis was carried out. Chi-square/2 × 2, 2 × 3, 3 × 3, Fisher Exact test have been used to find the significance of study parameters on categorical scale between two or more groups.ResultsPatients with a Mallampatti score of three or four were found to have worse laryngoscopic views (Cormack-Lehane score, 3 or 4). Of all airway indicators assessed, an increased Mallampatti score was found to have significant correlation with increased difficulty in intubation. The use of RSI was associated with better laryngoscopic views, and easier intubations.ConclusionsAn airway assessment using the Mallampatti score is invaluable as a tool to predict a difficult airway and should be performed routinely if possible. RSI aids intubation ease. If not otherwise contraindicated, it should be performed routinely for all intubations in the ED.

4 keywords...

hide…