• Resuscitation · May 2017

    Multicenter Study Observational Study

    Techniques and outcomes of emergency airway management in Japan: An analysis of two multicentre prospective observational studies, 2010-2016.

    • Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa, and Japanese Emergency Medicine Network Investigators.
    • Department of Emergency Medicine, Nagoya Ekisaikai Hospital, 4-66 Shonen, Nakagawa, Nagoya, Aichi 454-8502, Japan. Electronic address: gotoyu@ekisai.or.jp.
    • Resuscitation. 2017 May 1; 114: 14-20.

    ObjectivesContinuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan.MethodsWe conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016.ResultsWe recorded 10,927 ED intubations (capture rate, 96%); 10,875 paediatric and adult patients were eligible for our analysis. The rate of rapid sequence intubation (RSI) use as the initial intubation method significantly increased from 28% in 2010 to 53% in 2016 (Ptrend=0.03). Likewise, the rate of video laryngoscope (VL) use as the first intubation device increased significantly from 2% in 2010 to 40% in 2016 (Ptrend<0.001), with a significant decrease in the rate of direct laryngoscope use from 97% in 2010 to 58% in 2016 (Ptrend<0.001). Concurrent with these changes, the overall first-attempt success rate also increased from 68% in 2010 to 74% in 2016 (Ptrend=0.02). By contrast, the rate of adverse events did not change significantly over time (Ptrend=0.06).ConclusionBy using data from two large, multicentre, prospective registries, we characterised the current emergency airway management practice, and identified their changes in Japan. The data demonstrated significant increases in the rate of RSI and VL use on the first attempt and the first-attempt success rate over the 6-year study period.Copyright © 2017 Elsevier B.V. All rights reserved.

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