Table 3.
Comparison of ED to OR intubations (n = 1273)
| Variable | Intubation location no. (%) | p-value | |
|---|---|---|---|
| ED (n = 948) | OR (n = 325) | ||
| Induction medication | |||
| None | 21 (2.2) | 1 (0.3%) | < 0.001 |
| Propofol | 5 (0.5%) | 219 (67.4%) | |
| Ketamine | 68 (7.2%) | 76 (23.4%) | |
| Etomidate | 849 (89.6%) | 15 (4.6%) | |
| Midazolam | 1 (0.1%) | 6 (1.9%) | |
| Fentanyl | 3 (0.3%) | 8 (2.5%) | |
| Other | 1 (0.1%) | 0 | |
| Neuromuscular medication | |||
| None | 9 (1.0%) | 14 (4.3%) | < 0.001 |
| Succinylcholine | 638 (67.3%) | 167 (51.4%) | |
| Rocuronium | 292 (30.8%) | 135 (41.5%) | |
| Vecuronium | 6 (0.6%) | 6 (1.9%) | |
| Cisatracurium | 0 | 2 (0.6%) | |
| Mivacurium | 1 (0.1%) | 0 | |
| Other | 2 (0.2%) | 1 (0.3%) | |
| Specialty of provider | |||
| ED | 919 (96.9%) | 2 (0.6%) | < 0.001 |
| Anesthesiologist | 1 (0.1%) | 294 (90.5%) | |
| Surgeon | 1 (0.1%) | 1 (0.3%) | |
| Critical care specialist | 0 | 6 (1.9%) | |
| Unknown/other | 27 (2.9%) | 22 (6.8%) | |
| Provider training | |||
| Attending | 67 (7.6%) | 25 (8.2%) | < 0.001 |
| Resident | 598 (67.6%) | 175 (57.6%) | |
| Fellow | 1 (0.1%) | 0 | |
| CRNA | 0 | 39 (12.8%) | |
| Student | 1 (0.1%) | 8 (2.6%) | |
| Unknown/other | 218 (24.6%) | 57 (18.8%) | |
| Intubating technique | |||
| Asleep direct laryngoscopy | 490 (55.4%) | 184 (61.7%) | < 0.001 |
| Asleep videolaryngoscopy | 295 (33.4%) | 69 (23.1%) | |
| Asleep LMA/supraglottic airway | 0 | 2 (0.7%) | |
| Asleep fiberoptic | 9 (1.0%) | 8 (2.7%) | |
| Awake direct laryngoscopy | 9 (1.0%) | 0 | |
| Awake videolaryngoscopy | 3 (0.3%) | 1 (0.3%) | |
| Awake fiberoptic | 1 (0.1%) | 1 (0.3%) | |
| Surgical airway | 1 (0.1%) | 14 (4.7%) | |
| Unknown/other | 76 (8.6%) | 19 (6.4%) | |
| DL blade | |||
| Macintosh | 412 (53.7%) | 190 (69.1%) | < 0.001 |
| Miller | 10 (1.3%) | 4 (1.5%) | |
| Other | 3 (0.4%) | 0 | |
| Unknown | 343 (44.7%) | 81 (29.5%) | |
| Location of ETT | |||
| Oral | 848 (95.7%) | 277 (93.5%) | < 0.001 |
| Nasal | 6 (0.7%) | 1 (0.3%) | |
| Tracheal | 2 (0.2%) | 1 (0.3%) | |
| NS | 30 (3.4%) | 17 (5.7%) | |
| Number of intubation attemptsa | 1 (1–1) | 1 (1–1) | 0.26 |
| In-hospital mortalityb | 247 (26.1%) | 18 (5.5%) | < 0.001 |
| Complicationb | 674 (71.1%) | 131 (40.3%) | < 0.001 |
| Hypotension 24 h post intubationb | 282 (31.6%) | 84 (26.9%) | 0.37 |
| Vasopressor requirement 24 h post intubationb | 187 (21.6%) | 74 (24.1%) | 0.94 |
Total n for Table 3 excludes patients who were intubated in locations other than the ED and OR
ED emergency department, OR operating room, CRNA certified registered nurse anesthetist, LMA laryngeal mask airway, NS not specified
aMedian (IQR); p-value calculated by the Wilcoxon rank sum test
bp-value calculated by the Cochran–Mantel–Haenszel test, adjusting for hospital site