Trauma airway experience by emergency physicians

The objective of this study was to evaluate the success rates of endotracheal intubation of trauma patients by emergency physicians and to determine if there are areas in which the care of these patients could be improved. This was a retrospective observational study of 142 major trauma patients who required advanced airway management. The median age was 32 years and 74% of the patients were men. Fifty per cent had isolated head injury. The main indications for intubation were a Glasgow Coma Score of less than 9 (40.1%), trauma arrest (24.6%), and prophylactic protection of the airway (10.6%). Emergency physicians successfully intubated 90.8% of the patients. The pretreatment of head-injured patients with lignocaine was performed in only six out of 66 indicated cases (9.1%). The complication rate was 23.2%. Hypotension occurred in 22.9% of cases treated with midazolam, and was more common than in those who were intubated without a sedating agent [odds ratio (OR) 3.108; 95% confidence interval (CI) 1.060, 9.109]. (C) 2003 Lippincott Williams & Wilkins.