Skip to main content
Journal cover image

Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS).

Publication ,  Journal Article
Capone, CA; Emerson, B; Sweberg, T; Polikoff, L; Turner, DA; Adu-Darko, M; Li, S; Glater-Welt, LB; Howell, J; Brown, CA; Donoghue, A; Swain, K ...
Published in: Acad Emerg Med
April 2022

BACKGROUND: Tracheal intubation (TI) practice across pediatric emergency departments (EDs) has not been comprehensively reported. We aim to describe TI practice and outcomes in pediatric EDs in contrast to those in intensive are units (ICUs) and use the data to identify quality improvement targets. METHODS: Consecutive TI encounters from pediatric EDs and ICUs in the National Emergency Airway Registry for Children (NEAR4KIDS) database from 2015 to 2018 were analyzed for patient, provider, and practice characteristics and outcomes: adverse TI-associated events (TIAEs), oxygen desaturation (SpO2 < 80%), and procedural success. A multivariable model identified factors associated with TIAEs in the ED. RESULTS: A total of 756 TIs in 13 pediatric EDs and 12,512 TIs in 51 pediatric/cardiac ICUs were reported. Median (interquartile range [IQR]) patient age for ED TIs was higher (32 [7-108] months) than that for ICU TIs (15 [3-91] months; p < 0.001). Proportion of TIs for respiratory decompensation (52% of ED vs. 64% ICU), shock (26% vs. 14%), and neurologic deterioration (30% vs. 11%) also differed by location. Limited neck mobility was reported more often in the ED (16% vs. 6%). TIs in the ED were performed more often via video laryngoscopy (64% vs. 29%). Adverse TIAE rates (15.6% ED, 14% ICU; absolute difference = 1.6%, 95% confidence interval [CI] = -1.1 to 4.2; p = 0.23) and severe TIAE rates (5.4% ED, 5.8% ICU; absolute difference = -0.3%, 95% CI = -2.0 to 1.3; p = 0.68) were not different. Oxygen desaturation was less commonly reported in ED TIs (13.6%) than ICU TIs (17%, absolute difference = -3.4%, 95% CI = -5.9 to -0.8; p = 0.016). Among ED TIs, shock as an indication (adjusted odds ratio [aOR] = 2.15, 95% CI = 1.26 to 3.65) and limited mouth opening (aOR = 1.74, 95% CI = 1.04 to 2.93) were independently associated with TIAEs. CONCLUSIONS: While TI characteristics vary between pediatric EDs and ICUs, outcomes are similar. Shock and limited mouth opening were independently associated with adverse TI events in the ED.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

April 2022

Volume

29

Issue

4

Start / End Page

406 / 414

Location

United States

Related Subject Headings

  • Registries
  • Oxygen
  • Intubation, Intratracheal
  • Intensive Care Units, Pediatric
  • Humans
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine
  • Child, Preschool
  • Child
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Capone, C. A., Emerson, B., Sweberg, T., Polikoff, L., Turner, D. A., Adu-Darko, M., … National Emergency Airway Registry for Children (NEAR4KIDS) Investigators, Pediatric Acute Lung Injury, Sepsis Investigators (PALISI). (2022). Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med, 29(4), 406–414. https://doi.org/10.1111/acem.14431
Capone, Christine A., Beth Emerson, Todd Sweberg, Lee Polikoff, David A. Turner, Michelle Adu-Darko, Simon Li, et al. “Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS).Acad Emerg Med 29, no. 4 (April 2022): 406–14. https://doi.org/10.1111/acem.14431.
Capone CA, Emerson B, Sweberg T, Polikoff L, Turner DA, Adu-Darko M, et al. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2022 Apr;29(4):406–14.
Capone, Christine A., et al. “Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS).Acad Emerg Med, vol. 29, no. 4, Apr. 2022, pp. 406–14. Pubmed, doi:10.1111/acem.14431.
Capone CA, Emerson B, Sweberg T, Polikoff L, Turner DA, Adu-Darko M, Li S, Glater-Welt LB, Howell J, Brown CA, Donoghue A, Krawiec C, Shults J, Breuer R, Swain K, Shenoi A, Krishna AS, Al-Subu A, Harwayne-Gidansky I, Biagas KV, Kelly SP, Nuthall G, Panisello J, Napolitano N, Giuliano JS, Emeriaud G, Toedt-Pingel I, Lee A, Page-Goertz C, Kimura D, Kasagi M, D’Mello J, Parsons SJ, Mallory P, Gima M, Bysani GK, Motomura M, Tarquinio KM, Nett S, Ikeyama T, Shetty R, Sanders RC, Lee JH, Pinto M, Orioles A, Jung P, Shlomovich M, Nadkarni V, Nishisaki A, National Emergency Airway Registry for Children (NEAR4KIDS) Investigators, Pediatric Acute Lung Injury, Sepsis Investigators (PALISI). Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2022 Apr;29(4):406–414.
Journal cover image

Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

April 2022

Volume

29

Issue

4

Start / End Page

406 / 414

Location

United States

Related Subject Headings

  • Registries
  • Oxygen
  • Intubation, Intratracheal
  • Intensive Care Units, Pediatric
  • Humans
  • Emergency Service, Hospital
  • Emergency & Critical Care Medicine
  • Child, Preschool
  • Child
  • 3202 Clinical sciences