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Characteristics and outcomes of prehospital and emergency department surgical airways.
Mathews, Amanda C; McLeod, Kaitlin; Lacy, Aaron J; High, Kevin; Brywczynski, Jeremy; McKinney, Jared J; Wrenn, Jesse O; Jones, Ian D; Stubblefield, William B.
Afiliação
  • Mathews AC; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • McLeod K; Department of Emergency Medicine Vanderbilt University School of Medicine Nashville Tennessee USA.
  • Lacy AJ; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • High K; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • Brywczynski J; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • McKinney JJ; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • Wrenn JO; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • Jones ID; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
  • Stubblefield WB; Department of Emergency Medicine Vanderbilt University Medical Center Nashville Tennessee USA.
J Am Coll Emerg Physicians Open ; 5(2): e13136, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38524352
ABSTRACT

Objectives:

The surgical airway is a high acuity, low occurrence procedure. Data on the complications and outcomes of surgical airways are limited. Our primary objective was to describe immediate complications, late complications, and clinical outcomes of patients who underwent a surgical airway procedure in the prehospital or emergency department (ED) setting.

Methods:

We conducted a retrospective chart review of patients ≥14 years at an academic medical center who underwent a surgical airway procedure in the ED, the prehospital setting, or at a referring ED prior to interfacility transfer. We identified cases from keyword searches of prehospital text pages and hospital electronic medical records from June 1, 2008 to July 1, 2022. Manual chart review was used to confirm inclusion and determine patient and procedure characteristics. Outcomes included immediate complications, delayed in-hospital complications, and neurologic disability as defined by Modified Rankin Score (mRS) at discharge.

Results:

We identified 63 patients (34 prehospital, 11 ED, and 18 referring ED). Immediate complications included mainstem intubation (46.0%) and bleeding that required direct pressure (23.4%). Overall, 29 patients (46%) died after arrival to the hospital. Of the patients surviving to hospital admission, 25 (48%) had an airway-related complication. Nine complications were deemed directly related to technical components of the procedure. Of the patients who survived to discharge, 18 (52.9%) had poor neurologic function (mRS 4-5).

Conclusion:

Procedural complications, mortality, and poor neurologic function were common following a surgical airway procedure in the prehospital or ED setting. Most patients surviving to discharge had a moderate to severe neurologic disability.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article