Assessment of Emergency Airway Management Techniques in Korea Using an Online Registration System: A Multicenter Study

• Published in: The Journal of emergency medicine 2015-01, Vol.48 (1), p.1-9
• Main Authors: Cho, Young Soon, MD, Cho, Junho, MD, Chung, Hyun Soo, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; airway; Clinical Competence; Emergency; Emergency Service, Hospital - statistics & numerical data; Female; Humans; Hypnotics and Sedatives - therapeutic use; Internet; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Intubation, Intratracheal - statistics & numerical data; Laryngoscopes; Laryngoscopy - methods; Male; Middle Aged; Outcome Assessment (Health Care); Prospective Studies; Registries; Republic of Korea; trauma; Video-Assisted Surgery
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2014.06.044

Abstract Background The investigators developed a Web-based online registration system to identify the current status of trauma airway management. Objectives The purpose of the study was to identify first-pass success (FPS) rate of the intubation methods and devices that are currently used, as well as the factors that affect FPS in trauma patients. Methods This study was designed as a prospective, observational multi-center study. We obtained clinical data of intubated trauma patients in 13 academic emergency departments in Korea. After performing an intubation, each patient's data were entered into a Web-based registry. Logistic regression analyses were conducted to identify the factors that affect FPS. Results The FPS rate was 80.6% in all trauma patients. The curved-blade laryngoscope was the most commonly used instrument, and was applied to 1395 patients (76.2%) during first attempt. Video laryngoscopy was applied to 341 patients (18.6%). In the multivariate logistic regression analysis, factors that affected FPS in difficult airway trauma patients were emergency physicians, senior physicians, and video laryngoscopy (odds ratio 2.42, 95% confidence interval 1.04–5.65; 1.80, 1.16–2.79; and 2.16, 1.39–3.33, respectively). Conclusions Emergency physicians in Korea are prepared for trauma patient airway management. The backup by experienced senior physicians, and preparation and training for video laryngoscope could assist FPS for trauma patients.