Brian Driver1, Kenneth Dodd2, Lauren R Klein2, Ryan Buckley3, Aaron Robinson2, John W McGill2, Robert F Reardon2, Matthew E Prekker4. 1. Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN. Electronic address: briandriver@gmail.com. 2. Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN. 3. University of Minnesota School of Medicine, Minneapolis, MN. 4. Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN; Division of Pulmonary/Critical Care, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN.
Abstract
STUDY OBJECTIVE: The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. METHODS: We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation. RESULTS: Intubation with a Macintosh blade was attempted in 543 cases; a bougie was used on the majority of initial attempts (80%; n=435). First-pass success was greater with than without bougie use (95% versus 86%; absolute difference 9% [95% confidence interval {CI} 2% to 16%]). The median first-attempt duration was higher with than without bougie (40 versus 27 seconds; difference 14 seconds [95% CI 11 to 16 seconds]). Bougie use was independently associated with greater first-pass success (adjusted odds ratio 2.83 [95% CI 1.35 to 5.92]). CONCLUSION: Bougie was associated with increased first-pass intubation success. Bougie use may be helpful in ED intubation.
STUDY OBJECTIVE: The bougie may improve first-pass intubation success in operating room patients. We seek to determine whether bougie use is associated with emergency department (ED) first-pass intubation success. METHODS: We studied consecutive adult ED intubations at an urban, academic medical center during 2013. Intubation events were identified by motion-activated video recording. We determined the association between bougie use and first-pass intubation success, adjusting for neuromuscular blockade, video laryngoscopy, abnormal airway anatomy, and whether the patient was placed in the sniffing position or the head was lifted off the bed during intubation. RESULTS: Intubation with a Macintosh blade was attempted in 543 cases; a bougie was used on the majority of initial attempts (80%; n=435). First-pass success was greater with than without bougie use (95% versus 86%; absolute difference 9% [95% confidence interval {CI} 2% to 16%]). The median first-attempt duration was higher with than without bougie (40 versus 27 seconds; difference 14 seconds [95% CI 11 to 16 seconds]). Bougie use was independently associated with greater first-pass success (adjusted odds ratio 2.83 [95% CI 1.35 to 5.92]). CONCLUSION: Bougie was associated with increased first-pass intubation success. Bougie use may be helpful in ED intubation.
Authors: Brian E Driver; Matthew E Prekker; Lauren R Klein; Robert F Reardon; James R Miner; Erik T Fagerstrom; Mitchell R Cleghorn; John W McGill; Jon B Cole Journal: JAMA Date: 2018-06-05 Impact factor: 56.272
Authors: Jason A Lesnick; Justin X Moore; Yefei Zhang; Jeffrey Jarvis; Graham Nichol; Mohamud R Daya; Ahamed H Idris; Cameron Klug; David Dennis; Jestin N Carlson; Pratik Doshi; George Sopko; Robert H Schmicker; Henry E Wang Journal: Resuscitation Date: 2020-12-02 Impact factor: 5.262
Authors: Brian Driver; Matthew W Semler; Matthew E Prekker; Jonathan D Casey; Wesley H Self; Adit A Ginde; Sheetal Gandotra; Stacy A Trent; Lane M Smith; John P Gaillard; David B Page; Micah R Whitson; Derek J Vonderhaar; A M Joffe; Jason R West; Christopher Hughes; Janna S Landsperger; Michelle P Howell; Derek W Russell; Swati Gulati; Itay Bentov; Steven Mitchell; Andrew Latimer; Kevin Doerschug; Vikas Koppurapu; Kevin W Gibbs; Li Wang; Christopher John Lindsell; David Janz; Todd W Rice Journal: BMJ Open Date: 2021-05-25 Impact factor: 2.692
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