Analysis of trauma intubations

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      The timing of trauma patient intubation is dependent on clinical presentation and clinician judgment. We sought to correlate the timing of intubation with the presenting of physiologic parameters and clinical outcome to identify potential quality assurance audit filters. Patients (n = 82) were grouped by timing of intubation: PREHOSPITAL, paramedic intubation; IMMEDIATE, within 10 minutes of arrival; DELAYED, beyond 10 minutes but within 2 hours of arrival; and NONURGENT, beyond 2 hours or at the time of surgery. While mean revised trauma scores and Glasgow Coma Scale (GCS) scores differed for the groups, the mean length of hospital stay and the incidence of aspiration pneumonia were not significantly different. In the DELAYED group, 80% of those who developed aspiration pneumonia had a GCS≤13. Patients in the NONURGENT group were older and commonly presented with tachypnea. The survival rate for the NONURGENT group was lower than predicted by the TRISS method (P = .004). A GCS≤13 and age greater than 50 years with presenting respiratory rates of more than 25 breaths/min represent potential trauma intubation audit filters.


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      1. Advanced Trauma Life Support Program: Instructor manual.
        American College of Surgeons, Chicago, IL1989
        • Lowe D
        • Pope R
        • Hedges J
        Time-management study of trauma resuscitation.
        Am J Surg. 1990; 159: 457-461
        • Teasdale G
        • Jennett B
        Assessment of coma and impaired consciousness: A practical guide.
        Lancet. 1974; 2: 81-84
        • Champion HR
        • Sacco WJ
        • Copes WS
        • et al.
        A revision of the trauma score.
        J Trauma. 1989; 29: 623-628
        • Baker SP
        • O'Neill B
        • Haddon W
        • et al.
        The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care.
        J Trauma. 1974; 14: 187-196
        • Lowe DK
        • Hedges JR
        • Marby DW
        • et al.
        An assessment of time following trauma resuscitation: The transitional evaluation and monitoring phase.
        J Trauma. 1991; 31: 1265-1269
        • Garner JS
        • Jarvis WR
        • Emori TG
        • et al.
        CDC definitions for nosocomial infections, 1988.
        Am J Infect Control. 1988; 16: 128-140
        • Boyd CR
        • Tolson MA
        • Copes WS
        Evaluating trauma care: The TRISS method.
        J Trauma. 1987; 27: 370-378
        • Hedges JR
        • Dronen SC
        • Feero S
        • et al.
        Succinylcholine-assisted intubations in prehospital care.
        Ann Emerg Med. 1988; 17: 469-472
        • Redan JA
        • Livingstone DH
        • Tortella BJ
        • et al.
        The value of intubating and paralyzing patients with suspected head injury in the emergency department.
        J Trauma. 1991; 31: 371-375
        • Browner WS
        • Black D
        • Newman TB
        • et al.
        Estimating sample size and power.
        in: Hully SB Cummings SR Designing Clinical Research. Williams & Wilkins, Baltimore, MD1988: 139-143
        • Barone JE
        • Pizzi WF
        • Nealon TF
        • et al.
        Indications for intubation in blunt chest trauma.
        J Trauma. 1986; 26: 334-338
        • Champion HR
        • Copes WS
        • Buyer D
        • et al.
        Major trauma in geriatric patients.
        Am J Public Health. 1984; 79: 565-572
        • Rhodes M
        • Sacco W
        • Smith S
        • et al.
        Cost effectiveness of trauma quality assurance audit filters.
        J Trauma. 1990; 30: 724-727