• Maria C Kaisler, Robert J Hyde, Benjamin J Sandefur, Amy H Kaji, Ronna L Campbell, Brian E Driver, and Calvin A Brown.
• Department of Emergency Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN, 55905, United States. Electronic address: kaisler.maria@mayo.edu.
• Am J Emerg Med. 2021 Nov 1; 49: 48-51.

ObjectiveTo describe awake intubation practices in the emergency department (ED) and report success, complications, devices used, and rescue techniques using multicenter surveillance.MethodsWe analyzed data from the National Emergency Airway Registry (NEAR). Patients with an awake intubation attempt between January 1, 2016 and December 31, 2018 were included. We report univariate descriptive data as proportions with cluster-adjusted 95% confidence intervals (CIs).ResultsOf 19,071 discrete patient encounters, an awake technique was used on the first attempt in 82 (0.4%) patients. The majority (91%) of first attempts were performed by emergency medicine physicians. Angioedema (32%) and non-angioedema airway obstruction (31%) were the most common indications for an awake intubation attempt. The most common initial device used was a flexible endoscope (78%). Among all awake intubations first-attempt success was achieved in 85% (95% CI [76%-95%]), and peri-intubation complications occurred in 16% (95% CI [9%-26%]).ConclusionAwake intubation in this multicenter cohort of emergency department patients was rare and was performed most often in patients with airway edema or obstruction. Emergency physicians performed the majority of first intubation attempts with high first-attempt success. Further studies are needed to determine optimal emergency airway management in this patient population.Copyright © 2021 Elsevier Inc. All rights reserved.

24 keywords...

hide…