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.