J Korean Soc Emerg Med.  1999 Sep;10(3):379-385.

Current Trends in Emergency Tracheal Intubation and Prediction of Difficult Intubation in ED

• Chung SP
• Im TH
• Chang WJ
• Kim SH
• Lee HS

Abstract

BACKGROUND: This study was designed to describe the current tends of emergency tracheal intubation and predict difficult airway intubations in emergency department (ED) at a teaching hospital in Korea.
METHODS
All patients who was taken endotracheal incubation in ED during a 1-year period (Mar 1997 through Feb 1998) were included in the study population. Medical records of the patients were retrospectively reviewed. Among them, 56 patients were prospectively evaluated parameters to predict difficult airway intubations.
RESULTS
During the study period, a total of 413 patients(1.5%) required endotracheal intubation. Except far 2 cases, all patients intubated orotracheally, and 298(72%) patients were intubated by emergency medicine resident. Pharmacologic adjuncts were used in 200(48%) patients, the neuromuscular blocking agent(NMBA) was used in 16(3.8%) Commonly used drugs were thiopental and vecuronium. The difficult incubation was not associated with presence of denture, length and circumference of neck, and mental status. The visibility of vocal cord on laryngoscopy significantly correlated to the difficult airway.
CONCLUSION
At this institution, the majority of ED incubation were performed by emergency physicians and NMBA was not routinely used. The visibility of vocal cord during the direct laryngoscopy could be a predictor of difficult incubation in ED.

MeSH Terms

Dentures
Emergencies*
Emergency Medicine
Emergency Service, Hospital
Hospitals, Teaching
Humans
Intubation*
Intubation, Intratracheal
Korea
Laryngoscopy
Medical Records
Neck
Neuromuscular Blockade
Prospective Studies
Retrospective Studies
Thiopental
Vecuronium Bromide
Vocal Cords
Thiopental
Vecuronium Bromide