INCIDENCE OF ASPIRATION AFTER URGENT INTUBATION

This study sought to determine the incidence of aspiration after urgen t endotracheal intubation (ET) performed in the emergency department ( ED), and to offer a descriptive evaluation of these intubations. in a retrospective review of 133 charts, 87 patients met inclusion criteria . Aspiration occurred in 3 (3.5%) patients (95% confidence interval, 0 %, 7.4%). One had witnessed aspiration, and 2 had positive sputum cult ures. None of the 87 patients had a positive chest radiograph or unexp lained hypoxemia up to 48 hours after ET. Rapid sequence induction and oral ET was performed in 79 (91%) patients, whereas 4 spontaneously b reathing patients were nasally intubated. Seventy percent of patients underwent ET by PGY I or II residents, 29% by PGY III or IV residents, and 1% by ED attending physicians, Seventy seven patients were intuba ted on the first attempt, acid airway blood or vomitus during ET was n oted in 11 patients. This study offers significant descriptive informa tion regarding urgent ET performed in the ED, and shows that aspiratio n after urgent ET occurs infrequently in ED patients. Copyright (C) 19 97 by W.B. Saunders Company.