• Am J Emerg Med · Mar 2020

    Factors associated with post-intubation sedation after emergency department intubation: A Report from The National Emergency Airway Registry.

    • Olga Lembersky, Dustin Golz, Casey Kramer, Andrea Fantegrossi, Jestin N Carlson, Ron M Walls, Calvin A Brown, and NEAR Investigators.
    • Department of Emergency Medicine, Saint Vincent Hospital, Erie, PA, United States of America.
    • Am J Emerg Med. 2020 Mar 1; 38 (3): 466-470.

    BackgroundPrevious work has suggested low rates of post-intubation sedation in patients undergoing endotracheal intubation (ETI) in the emergency department (ED) with limited data examining factors associated with sedation use. Utilizing a national database; we sought to determine the frequency of post-intubation sedation and associated factors.MethodsWe performed a retrospective analysis of a prospectively collected database (National Emergency Airway Registry (NEAR) from 25 EDs from January 1, 2016 to December 31, 2017). Patients were considered to have received post-intubation sedation if they received any of the following medications within 15 min of ETI completion; propofol, midazolam, diazepam, ketamine, etomidate, fentanyl, and morphine. We calculated odds ratios for post-intubation sedation.ResultsOf the 11,748 eligible intubations, 9099 received post-intubation sedation (77.5%) while 2649 did not (22.5%). Pre-intubation hypotension (odds ratio; 95% confidence Interval) (0.27; 0.24-0.31) and post-intubation hypotension (0.27; 0.24-0.31) were associated with lower odds of post-intubation sedation. Patients with a medical indication compared to a traumatic indication for ETI had higher odds of receiving post-intubation sedation (1.16; 1.05-1.28) as did those that underwent rapid sequence intubation (15.15; 13.56-16.93). Use of succinylcholine was associated with a higher odd of post-intubation sedation compared to a long-acting neuromuscular blocking agent (i.e. rocuronium or vecuronium) (1.89; 1.68-2.12).ConclusionPost-intubation sedation rates in NEAR are higher than previously reported and multiple factors including the indication for intubation and succinylcholine use, are associated with higher odds of receiving post-intubation sedation.Copyright © 2019 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…