Table 2.
Data regarding analgesia, sedation, and neuromuscular blocker use in the emergency department.
| Variable | All Subjects (n = 388) |
Patients with AWP (n = 13) |
Patients without AWP (n = 375) |
Odds Ratio or Between- Group Differencea (95% CI) |
|---|---|---|---|---|
| RSI Variables * | ||||
| Etomidate, n (%) | 235 (60.6) | 8 (61.5) | 227 (60.5) | 1.04 (0.34-3.25) |
| Dose (mg) | 20 (20 - 30) | 20 (20 - 30) | 20 (20 - 30) | 0.26 (−7.51 to 8.04) |
| Weight-Based Dose (mg/kg) | 0.27 (0.21 - 0.32) | 0.29 (0.18 - 0.31) | 0.26 (0.22 - 0.32) | −0.02 (−0.11 to 0.07) |
| Ketamine, n (%) | 131 (33.8) | 5 (38.5) | 126 (33.6) | 1.24 (0.40-3.85) |
| Dose (mg) | 100 (100 - 150) | 100 (62 - 155) | 100 (100 - 150) | −11.9 (−60.0 – 36.0) |
| Weight-Based Dose (mg/kg) | 1.30 (1.09 - 1.66) | 0.85 (0.59 - 1.79) | 1.30 (1.10 - 1.66) | −0.37 (−0.98 - 0.23) |
| Succinylcholine, n (%) | 155 (39.9) | 3 (23.1) | 152 (40.5) | 0.44 (0.12-1.63) |
| Dose (mg) | 100 (100 - 120) | 125 (100 - NA) | 100 (100 - 120) | 15.5 (−33.7 to 64.6) |
| Weight-Based Dose (mg/kg) | 1.32 (1.12 - 1.51) | 1.11 (0.85 - NA) | 1.32 (1.14 - 1.52) | −0.24 (−0.77 to 0.28) |
| Rocuronium, n (%) | 217 (55.9) | 10 (76.9) | 207 (55.2) | 2.71 (0.73-9.99) |
| Dose (mg) | 100 (100 - 100) | 100 (100 - 110) | 100 (100 - 100) | 3.2 (−14.2 to 20.5) |
| Weight-Based Dose (mg/kg) | 1.17 (1.00 – 1.39) | 1.06 (0.92 – 1.34) | 1.17 (1.0 - 1.39) | −0.08 (−0.31 to 0.16) |
| ED Post-Intubation Variables | ||||
| Fentanyl, n (%) | 331 (85.3) | 12 (92.3) | 319 (85.1) | 2.11 (0.27 – 16.5) |
| Cumulative Dose (mcg) | 400 (200 - 750) | 338 (125 - 763) | 400 (200 - 750) | −25 (−281 to 231) |
| Weight-Based Dose (mcg/kg) | 5.0 (2.0 – 9.1) | 3.5 (1.4 – 9.3) | 5.2 (2. 0 - 9.1) | −1.0 (−4.34 to 2.27) |
| Propofol, n (%) | 304 (78.4) | 10 (76.9) | 294 (78.4) | 0.92 (0.25 – 3.42) |
| Cumulative Dose (mg) | 248 (38 - 663) | 252 (42 - 1457) | 248 (37 - 659) | 200 (−141 to 543) |
| Weight-Based Dose (mg/kg) | 3.2 (0.6 – 8.1) | 3.6 (0.6 – 13.4) | 3.0 (0.6 – 8.1) | 1.2 (−2.1 to 4.4) |
| Midazolam, n (%) | 96 (24.7) | 4 (30.8) | 92 (24.5) | 1.37 ( 0.41 – 4.54) |
| Cumulative Dose (mg) | 6.0 (4.0 – 10.0) | 5.0 (2.0 – 5.8) | 7.0 (4.0 – 10.0) | −4.8 (−15.9 to 6.2) |
| Weight-Based Dose (mg/kg) | 0.07 (0.04 – 0.14) | 0.05 (0.02 – 0.06) | 0.07 (0.04 - 0.14) | −0.07 (−0.24 to 0.10) |
| Dexmedetomidine, n (%) | 37 (9.5) | 1 (7.7) | 36 (9.6) | 0.79 (0.10 – 6.21) |
| Cumulative Dose (mg) | 1.5 (0.4 – 3.2) | 0.40 (NA) | 1.5 (0.4 – 3.3) | −1.7 (−6.7 to 3.4) |
| Weight-Based Dose (mg/kg) | 0.02 (0.01 – 0.04) | 0.004 (NA) | 0.02 (0.01 – 0.04) | −0.02 (−0.09 to 0.04) |
| Lorazepam, n (%) | 20 (5.2) | 1 (7.7) | 19 (5.1) | 1.56 (0.19 – 12.64) |
| Cumulative Dose (mg) | 2.0 (1.0 – 2.0) | 1.0 (NA) | 2.0 (1.0 – 2.0) | −1.3 (−5.0 to 2.4) |
| Weight-Based Dose (mg/kg) | 0.03 (0.01 - 0.04) | 0.01 (NA) | 0.03 (0.01 - 0.04) | −0.02 (−0.07 to 0.03) |
| Ketamine, n (%) | 41 (10.6) | 2 (15.4) | 39 (10.4) | 1.57 (0.34 – 7.33) |
| Cumulative Dose (mg) | 100 (40 - 200) | 75 (50 – NA) | 100 (40 - 200) | −83 (−301 to 137) |
| Weight-Based Dose (mg/kg) | 1.25 (0.40 – 2.63) | 0.65 (0.45 - NA) | 1.34 (0.38 – 2.65) | −1.05 (−3.08 to 0.98) |
| Rocuroniumb, n (%) | 16 (4.1) | 2 (15.4) | 14 (3.7) | 4.69 (0.95 – 23.19) |
| Cumulative Dose (mg) | 100 (53 - 100) | 100 (100 - NA) | 100 (50 - 100) | 10 (−64 to 83) |
| Weight-Based Dose (mg/kg) | 0.87 (0.63 – 1.08) | 0.88 (0.85 – NA) | 0.86 (0.58 – 1.14) | −0.06 (−0.94 to 0.82) |
| Sedation Depth Variables ** | ||||
| Median RASS in ED | −2 (−3 to 0) | −2 (−3 to −1) | −2 (−3 to 0) | −0.3 (−2.3 to 1.6) |
| Median SAS in ED | 2 (1 – 3) | 3 (2 – 4) | 2 (1 – 3) | 0.5 (−0.6 to 1.7) |
| Deep Sedation, n (%) | 194 (50.0) | 7 (53.8) | 187 (49.9) | 1.17 (0.39 – 3.56) |
AWP = awareness with paralysis, CI = confidence interval, RSI = rapid sequence intubation, ED = emergency department, RASS = Richmond Agitation-Sedation Scale; SAS = Sedation-Agitation Scale
*
3 total patients were given midazolam and 6 were given propofol (no difference between groups). Data not shown due to space constraints.
**
823 sedation assessments were performed in the ED, on average 2.1 assessments per patient.
a
Odds ratio is presented for binary data and between-group difference is presented as the difference in means for the continuous data.
b
Refers to paralytic given as additional bolus after RSI
Continuous variables are reported as median (interquartile range).