World Journal of Emergency Medicine ›› 2024, Vol. 15 ›› Issue (6): 490-493.doi: 10.5847/wjem.j.1920-8642.2024.092
• Research Letters • Previous Articles Next Articles
Christian Hohenstein1(), Lucas Rudnik2, Frank Bloos3
Received:
2024-03-01
Accepted:
2024-07-17
Online:
2024-11-21
Published:
2024-11-01
Contact:
Christian Hohenstein, Email: Christian Hohenstein, Lucas Rudnik, Frank Bloos. Predictors of first-pass success intubations in the emergency departments in Germany: analysis of the German Airway Registry between 2015 and 2022[J]. World Journal of Emergency Medicine, 2024, 15(6): 490-493.
Add to citation manager EndNote|Ris|BibTeX
URL: http://wjem.com.cn/EN/10.5847/wjem.j.1920-8642.2024.092
Table 1.
Different factors with influence on first pass success
Factors | Number | FPS rate | P-value |
---|---|---|---|
Time (n=656) | 0.740 | ||
0:00-5:59 | 49 | 40 (81.6%) | |
6:00-11:59 | 193 | 168 (87.0%) | |
12:00-17:59 | 252 | 218 (86.5%) | |
18:00-23:59 | 162 | 137 (84.6%)) | |
Gender (n=656) | 0.009 | ||
Male | 366 | 303 (82.7%) | |
Female | 290 | 260 (89.8%) | |
Age, years (n=653) | 0.166 | ||
11-20 | 10 | 10 (100%) | |
21-30 | 11 | 7 (63.6%) | |
31-40 | 21 | 17 (81.0%) | |
41-50 | 47 | 42 (89.4%) | |
51-60 | 96 | 76 (79.2%) | |
61-70 | 148 | 131 (88.5%) | |
71-80 | 184 | 162 (88.0%) | |
81-80 | 125 | 106 (84.8%) | |
91-100 | 9 | 8 (88.9%) | |
>100 | 2 | 2 (100%) | |
Weight, kg (n=656) | 0.345 | ||
0-40 | 3 | 3 (100%) | |
41-80 | 421 | 368 (87.4%) | |
81-120 | 197 | 163 (82.7%) | |
121-140 | 22 | 20 (90.9%) | |
141-180 | 13 | 9 (69.2%) | |
Laryngoscopy (n=487) | 0.013 | ||
Direct | 165 | 129 (78.2%) | |
Video | 322 | 282 (87.5%) | |
Method (n=652) | 0.284 | ||
RSI | 512 | 437 (85.4%) | |
DSI | 75 | 69 (92.0%) | |
No medication | 37 | 30 (81.1%) | |
Awake intubation with topical anesthesia and sedation | 25 | 23 (92.0%) | |
Other | 3 | 2 (66.7%) | |
Indication (n=653) | 0.283 | ||
Neurology | 303 | 258 (85.1%) | |
Medicine | 226 | 201 (88.9%) | |
CPR without trauma | 59 | 46 (78.0%) | |
TBI | 20 | 16 (80.0%) | |
Polytrauma | 19 | 16 (84.2%) | |
CPR in traumatic CA | 2 | 1 (50.0%) | |
Other | 24 | 22 (91.7%) | |
Apneic oxygenation (n=656) | 0.012 | ||
Yes | 200 | 160 (80.0%) | |
No | 456 | 403 (88.4%) |
[1] |
Girrbach FF, Hilbig F, Michael M, Bernhard M. Systematic analysis of airway registries in emergency medicine. Anaesthesist. 2018; 67(9): 664-73.
doi: 10.1007/s00101-018-0476-8 pmid: 30105516 |
[2] |
Debus F, Lefering R, Frink M, Kühne CA, Mand C, Bücking B, et al. Numbers of severely injured patients in Germany. A retrospective analysis from the DGU (German Society for Trauma Surgery) trauma registry. Dtsch Arztebl Int. 2015; 112(49): 823-9.
doi: 10.3238/arztebl.2015.0823 pmid: 26754119 |
[3] | Walls RM, Brown CA 3rd, Bair AE, Pallin DJ; NEAR II Investigators. Emergency airway management:a multi-center report of 8937 emergency department intubations. J Emerg Med. 2011; 41(4): 347-54. |
[4] | Pallin DJ, Dwyer RC, Walls RM,Brown CA 3rd; NEAR III Investigators. Techniques and trends, success rates, and adverse events in emergency department pediatric intubations: a report from the national emergency airway registry. Ann Emerg Med. 2016; 67(5): 610-5.e1. |
[5] | Nishisaki A, Turner DA, Brown CA 3rd, Walls RM, Nadkarni VM; National Emergency Airway Registry for Children Network. A National Emergency Airway Registry for Children: landscape of tracheal intubation in 15 PICUs. Crit Care Med. 2013; 41(3): 874-85. |
[6] | Brown CA 3rd, Cox K, Hurwitz S, Walls RM. 4, 871 emergency airway encounters by air medical providers: a report of the air transport emergency airway management (NEAR VI:“A-TEAM”) project. West J Emerg Med. 2014; 15(2): 188-93. |
[7] |
Waack J, Shepherd M, Andrew E, Bernard S, Smith K. Delayed sequence intubation by intensive care flight paramedics in Victoria, Australia. Prehosp Emerg Care. 2018; 22(5): 588-94.
doi: 10.1080/10903127.2018.1426665 pmid: 29405806 |
[8] | Wilhelms SB, Wilhelms DB. Airway management procedures in Swedish emergency department patients - a national retrospective study. BMC Emerg Med. 2022; 22(1): 67. |
[9] | Goto Y, Goto T, Hagiwara Y, Tsugawa Y, Watase H, Okamoto H, et al. Techniques and outcomes of emergency airway management in Japan: an analysis of two multicentre prospective observational studies, 2010-2016. Resuscitation. 2017;114: 14-20. |
[10] |
Alkhouri H, Vassiliadis J, Murray M, MacKenzie J, Tzannes A, McCarthy S, et al. Emergency airway management in Australian and New Zealand emergency departments: a multicentre descriptive study of 3710 emergency intubations. Emerg Med Australas. 2017; 29(5): 499-508.
doi: 10.1111/1742-6723.12815 pmid: 28582801 |
[11] | Umana E, Foley J, Grossi I, Deasy C, O’Keeffe F; Irish Trainee Emergency Research Network Collaborators. National Emergency Resuscitation Airway Audit (NERAA): a pilot multicentre analysis of emergency intubations in Irish emergency departments. BMC Emerg Med. 2022; 22(1): 91. |
[12] | Eaton B, O’Meara L, Aresco C, Scalea T, Diaz J, Bruns B. The evolution of emergency general surgery: its time for a dedicated program manager. Eur J Trauma Emerg Surg. 2022; 48(1): 5-11. |
[13] | Pepe PE, Roppolo LP, Fowler RL. Prehospital endotracheal intubation: elemental or detrimental? Crit Care. 2015; 19(1): 121. |
[14] | Montag S, Herdtle S, John S, Lehmann T, Behringer W, Hohenstein C. Association between prehospital FPS and ROSC in adults with OHCA: a retrospective multicenter study using the German Resuscitation Registry and Intubation Registry (FiPS-CPR). Anaesthesiologie. 2022; 71(Suppl 2): 198-203. |
[15] | Reinert L, Herdtle S, Hohenstein C, Behringer W, Arrich J. Predictors for prehospital first-pass intubation success in Germany. J Clin Med. 2022; 11(3): 887. |
[16] | Reinert L, Herdtle S, Hohenstein C, Behringer W, Arrich J. Prehospital advanced airway management in two German cities. Notfall- und Rettungsmedizin. 2022; 7:1-6. [Article in German] |
[17] | Jarvis JL, Wampler D, Wang HE. Association of patient age with first pass success in out-of-hospital advanced airway management. Resuscitation. 2019;141: 136-43. |
[18] |
Jung W, Kim J. Factors associated with first-pass success of emergency endotracheal intubation. Am J Emerg Med. 2020; 38(1): 109-13.
doi: S0735-6757(19)30619-9 pmid: 31843066 |
[19] | Hindman BJ, Dexter F, Gadomski BC, Bucx MJ. Sex-specific intubation biomechanics: intubation forces are greater in male than in female patients, independent of body weight. Cureus. 2020; 12(6): e8749. |
[20] | Bakhsh A, Alharbi A, Almehmadi R, Kamfar S, Aldhahri A, Aledeny A, et al. Improving first-pass success rates during emergency intubation at an academic emergency department: a quality improvement initiative. Int J Qual Health Care. 2021; 33(3): mzab132. |
[21] | Huebinger RM, Stilgenbauer H, Jarvis JL, Ostermayer DG, Schulz K, Wang HE. Video laryngoscopy for out of hospital cardiac arrest. Resuscitation. 2021;162: 143-8. |
[22] | Li T, Jafari D, Meyer C, Voroba A, Haddad G, Abecassis S, et al. Video laryngoscopy is associated with improved first-pass intubation success compared with direct laryngoscopy in emergency department trauma patients. J Am Coll Emerg Physicians Open. 2021; 2(1): e12373. |
[23] |
Ruderman BT, Mali M, Kaji AH, Kilgo R, Watts S, Wells R, et al. Direct vs video laryngoscopy for difficult airway patients in the emergency department: a national emergency airway registry study. West J Emerg Med. 2022; 23(5): 706-15.
doi: 10.5811/westjem.2022.6.55551 pmid: 36205675 |
[24] |
Vassiliadis J, Tzannes A, Hitos K, Brimble J, Fogg T. Comparison of the C-MAC video laryngoscope with direct Macintosh laryngoscopy in the emergency department. Emerg Med Australas. 2015; 27(2): 119-25.
doi: 10.1111/1742-6723.12358 pmid: 25640845 |
[25] |
Sakles JC, Mosier JM, Patanwala AE, Arcaris B, Dicken JM. First pass success without hypoxemia is increased with the use of apneic oxygenation during rapid sequence intubation in the emergency department. Acad Emerg Med. 2016; 23(6): 703-10.
doi: 10.1111/acem.12931 pmid: 26836712 |
[26] |
Bernhard M, Becker TK, Gries A, Knapp J, Wenzel V. The first shot is often the best shot: first-pass intubation success in emergency airway management. Anesth Analg. 2015; 121(5): 1389-93.
doi: 10.1213/ANE.0000000000000891 pmid: 26484464 |
[27] | Olvera D, Patanwala A, Wolfe A Jr, Sakles J. First pass success is important in prehospital tracheal intubation to minimise the risk of physiologic deterioration. Br J Anaesth. 2020; 125(1): e202-e203. |
[28] |
Hossfeld B, Jongebloed A, Lampl L, Helm M. Out-of-hospital airway management in trauma patients: experiences with the C-MAC® video laryngoscope. Unfallchirurg. 2016; 119(6): 501-7.[Article in German]
doi: 10.1007/s00113-014-2642-z pmid: 25135707 |
[29] | Hossfeld B, Thierbach S, Allgoewer A, Gaessler H, Helm M. First pass success of tracheal intubation using the C-MAC PM videolaryngoscope as first-line device in prehospital cardiac arrest compared with other emergencies: an observational study. Eur J Anaesthesiol. 2021; 38(8): 806-12. |
[30] | Bernhard M, Bax SN, Hartwig T, Yahiaoui-Doktor M, Petros S, Bercker S, et al. Airway management in the emergency department (The OcEAN-Study) - a prospective single centre observational cohort study. Scand J Trauma Resusc Emerg Med. 2019; 27(1): 20. |
[31] | Choi HJ, Je SM, Kim JH, Kim E; Korean Emergency Airway Registry Investigators. The factors associated with successful paediatric endotracheal intubation on the first attempt in emergency departments: a 13-emergency-department registry study. Resuscitation. 2012; 83(11): 1363-8. |
[32] | Nauka PC, Moskowitz A, Siev A, Shiloh AL, Eisen LA, Fein DG. Obesity is unlikely to be an impediment to first-pass success during the intubation of critically ill patients. J Intensive Care Med. 2023; 38(9): 816-24. |
[33] | Price J, Lachowycz K, Steel A, Moncur L, Major R, Barnard EBG. Intubation success in prehospital emergency anaesthesia: a retrospective observational analysis of the Inter-Changeable Operator Model (ICOM). Scand J Trauma Resusc Emerg Med. 2022; 30(1): 44. |
[34] | Ljungqvist H, Pirneskoski J, Saviluoto A, Setälä P, Tommila M, Nurmi J. Intubation first-pass success in a high performing pre-hospital critical care system is not associated with 30-day mortality: a registry study of 4496 intubation attempts. Scand J Trauma Resusc Emerg Med. 2022; 30(1): 61. |
[35] |
Fein DG, Zhao D, Swartz K, Nauka P, Andrea L, Aboodi M, et al. The impact of nighttime on first pass success during the emergent endotracheal intubation of critically ill patients. J Intensive Care Med. 2021; 36(12): 1498-506.
doi: 10.1177/0885066620965166 pmid: 33054483 |
[36] | Matsumura Y, Nakada TA, Shinozaki K, Tagami T, Nomura T, Tahara Y, et al. Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: a prospective observational study. Crit Care. 2016; 20(1): 141. |
[37] | Ayhan A, Kaplan S, Kayhan Z, Arslan G. Evaluation and management of difficult airway in obesity a single center retrospective study. Acta Clin Croat. 2016; 55(Suppl 1): 27-32. |
[38] |
Hubble MW, Wilfong DA, Brown LH, Hertelendy A, Benner RW. A meta-analysis of prehospital airway control techniques part II: alternative airway devices and cricothyrotomy success rates. Prehosp Emerg Care. 2010; 14(4): 515-30.
doi: 10.3109/10903127.2010.497903 pmid: 20809690 |
[39] |
Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013; 20(1): 71-8.
doi: 10.1111/acem.12055 pmid: 23574475 |
[40] |
Gellerfors M, Fevang E, Bäckman A, Krüger A, Mikkelsen S, Nurmi J, et al. Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations. Br J Anaesth. 2018; 120(5): 1103-9.
doi: S0007-0912(17)54237-3 pmid: 29661387 |
[41] |
Diggs LA, Yusuf JE W, De Leo G. An update on out-of-hospital airway management practices in the United States. Resuscitation. 2014; 85(7): 885-92.
doi: 10.1016/j.resuscitation.2014.02.032 pmid: 24642405 |
[42] | Sunde GA, Heltne JK, Lockey D, Burns B, Sandberg M, Fredriksen K, et al. Airway management by physician-staffed Helicopter Emergency Medical Services - a prospective, multicentre, observational study of 2, 327 patients. Scand J Trauma Resusc Emerg Med. 2015;23: 57. |
No related articles found! |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||