Endotracheal intubations at the medeor institute of emergency medicine: an audit

Emergency departments manage a variety of patients at their most vulnerable time. Among the interventions undertaken for stabilizing the patient, endotracheal intubation is fundamental. Being an academic emergency department, the Medeor institute of emergency medicine (MIEM) undertook an audit to study the elements of endotracheal intubations at MIEM. Therefore, all patients requiring endotracheal intubations at MIEM were included prospectively over a period of seven months. A total of 70 endotracheal intubations were undertaken at MIEM during this period of which only 4 were in pediatric age group. Over three fourths of all of the endotracheal intubations were performed by emergency residents - post graduation year 2, under supervision of emergency consultants. Moreover, the commonest cause of securing airway was due to poor Glasgow Coma Scale. It was observed that the first pass success rate of all endotracheal intubations at MIEM was 93%. About a fifth of these were difficult airways, ascertained using LEMON (≥ 1) and/or Cormack Lehane grading (≥ 2) and the first pass success rate in difficult airway was 67%. Additionally, the rest of the endotracheal intubations were successful in the second attempt. In conclusion, although very few patients presenting to MIEM required endotracheal intubation, the first pass success rate of difficult airway could be improved by video laryngoscope which is now available at MIEM.