Pediatric endotracheal intubations for airway management in the emergency department.
Emergency Medicine; Paediatrics and Child Health
The objective of this study was to determine indications, type of medications used, and immediate complications of pediatric endotracheal intubations in the emergency department.
A retrospective chart review was done on all pediatric patients (0-14 years old) who required endotracheal (ET) intubation for airway management in the Department of Emergency Medicine at Aga Khan University Hospital from January to December 2009. Data were collected on a preformed questionnaire for age, sex, indications, drugs used, and complications of pediatric ET intubations done in the emergency department. Dead-on-arrival patients and those intubated elsewhere were excluded.
A total of 83 pediatric intubations were done during the study period. Indications for ET intubations were respiratory failure in 51 (61%), unresponsiveness in 18 (22%), cardiac arrest in 8 (10%), and trauma in 6 cases (7%). Comorbid conditions were present in 28 (34%). Of 83 ET intubations, drugs were used in 48 cases (58%). Both sedation and neuromuscular blockade were used in 42 cases (51%), 4 cases (5%) received sedation only, and 2 cases (2%) received relaxation without sedation, and in 35 cases (42%), intubation was done without drugs. Drugs used for sedation/induction were ketamine in 22 (26%), midazolam in 14 (17%), propofol in 7 (8%), and etomidate in 3 cases (4%). Neuromuscular blockades used were rocuronium in 27 cases (32%), succinylcholine in 11 cases (13.5%), and atracurium in 5 cases (6%). Complications were noted in 16 cases (19%).
Respiratory failure was found to be the main presenting complaint. Drugs for sedation and relaxation to facilitate ET intubation were underused.
Pediatric Emergency Care
Khan, U. R.,
(2012). Pediatric endotracheal intubations for airway management in the emergency department.. Pediatric Emergency Care, 28(11), 1129-1131.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_emerg_med/156
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