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Abstract
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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Article Info
Publication History
Accepted:
May 5,
1992
Received:
December 3,
1991
Identification
Copyright
© 1992 Published by Elsevier Inc.
