UMEM Educational Pearls

Category: Airway Management

Title: Anticipate the worst: major events peri-intubation

Keywords: major adverse event, airway, management, cardiovascular collapse (PubMed Search)

Posted: 7/30/2023 by Robert Flint, MD (Updated: 5/29/2024)
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This systemic review and meta analysis looked at major adverses events (hypoxia, cardiovascular instability, or cardiac arrest) in patients intubated in emergency departments, ICU’s, or medical floors. They found nearly 1/3 of patents had an event. ICU intubation and patients with pre-existing hemodynamic compromise had the highest rate of adverse outcomes. This study gives further support to the concept of maximizing resuscitation pre-intubation and to anticipate a major event peri-intubation. Be prepared and don't be surprised when something doesn't go as planned.

References

Jessica Downing, Isha Yardi, Christine Ren, Stephanie Cardona, Manahel Zahid, Kaitlyn Tang, Vera Bzhilyanskaya, Priya Patel, Ali Pourmand, Quincy K. Tran,
Prevalence of peri-intubation major adverse events among critically ill patients: A systematic review and meta analysis,
The American Journal of Emergency Medicine,
Volume 71,
2023,
Pages 200-216,
ISSN 0735-6757,
https://doi.org/10.1016/j.ajem.2023.06.046.