Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study
Aim Tracheal intubation is a vital resuscitation procedure in the pediatric emergency department (ED). Despite its importance, little is known about the current status of emergency airway management in Japan. In this context, we aimed to investigate the airway management characteristics—particularly...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Acute Medicine & Surgery |
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| Online Access: | https://doi.org/10.1002/ams2.798 |
| _version_ | 1797976122602815488 |
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| author | Yusuke Hagiwara Tadahiro Goto Shima Ohnishi Daisuke Miyamoto Yuki Ikeyama Kunihiro Matsunami Kohei Hasegawa the Japanese Emergency Medicine Network Investigators |
| author_facet | Yusuke Hagiwara Tadahiro Goto Shima Ohnishi Daisuke Miyamoto Yuki Ikeyama Kunihiro Matsunami Kohei Hasegawa the Japanese Emergency Medicine Network Investigators |
| author_sort | Yusuke Hagiwara |
| collection | DOAJ |
| description | Aim Tracheal intubation is a vital resuscitation procedure in the pediatric emergency department (ED). Despite its importance, little is known about the current status of emergency airway management in Japan. In this context, we aimed to investigate the airway management characteristics—particularly the location, patient, and provider factors—in the pediatric ED. Methods We conducted a multicenter, prospective study of five pediatric EDs in Japan from October 2018 to June 2020. The study included all children (aged ≤18 years) who underwent intubation at the pre‐ED or ED setting by physicians and those who were transferred from the ED to the operation room (OR) or pediatric intensive care unit (PICU) for intubation. We described the airway management characteristics according to the location, patient, and provider factors. Results Of 231 children, 9 (4%) were transferred to the OR or PICU for airway management. Among the remaining 222 children, 45 were intubated at the pre‐ED setting and 177 were intubated in the ED. The overall first‐attempt success rate was 72%, with the rate varying by location, patient, and provider factors—for example, 68% at the pre‐ED setting, 67% for children <2 years, 56% for children with airway‐related anatomical anomalies, and 61% with intubation by a resident physician. Intubation‐related adverse events were observed in 17%, most of which were hypoxemia (14%). Conclusions Based on data from a multicenter prospective study, the overall first‐attempt intubation success rate in pediatric EDs in Japan was 72%, with large variations by location, patient, and provider factors. |
| first_indexed | 2024-04-11T04:46:20Z |
| format | Article |
| id | doaj.art-1cce1faef1434caeadf14031bcd7db5b |
| institution | Directory Open Access Journal |
| issn | 2052-8817 |
| language | English |
| last_indexed | 2024-04-11T04:46:20Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acute Medicine & Surgery |
| spelling | doaj.art-1cce1faef1434caeadf14031bcd7db5b2022-12-27T12:22:50ZengWileyAcute Medicine & Surgery2052-88172022-01-0191n/an/a10.1002/ams2.798Airway management in the pediatric emergency department in Japan: A multicenter prospective observational studyYusuke Hagiwara0Tadahiro Goto1Shima Ohnishi2Daisuke Miyamoto3Yuki Ikeyama4Kunihiro Matsunami5Kohei Hasegawa6the Japanese Emergency Medicine Network InvestigatorsDepartment of Pediatric Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center Tokyo JapanDepartment of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo JapanDivision of Emergency and Transport Services National Center for Child Health and Development Tokyo JapanDepartment of Pediatric Emergency Medicine Saitama Children's Medical Center Saitama JapanDepartment of Pediatric Emergency Medicine Aichi Children's Health and Medical Center Obu‐shi, Aichi JapanDepartment of Pediatrics Gifu Prefectural General Medical Center Gifu JapanDepartment of Emergency Medicine, Massachusetts General Hospital Harvard Medical School Boston MAAim Tracheal intubation is a vital resuscitation procedure in the pediatric emergency department (ED). Despite its importance, little is known about the current status of emergency airway management in Japan. In this context, we aimed to investigate the airway management characteristics—particularly the location, patient, and provider factors—in the pediatric ED. Methods We conducted a multicenter, prospective study of five pediatric EDs in Japan from October 2018 to June 2020. The study included all children (aged ≤18 years) who underwent intubation at the pre‐ED or ED setting by physicians and those who were transferred from the ED to the operation room (OR) or pediatric intensive care unit (PICU) for intubation. We described the airway management characteristics according to the location, patient, and provider factors. Results Of 231 children, 9 (4%) were transferred to the OR or PICU for airway management. Among the remaining 222 children, 45 were intubated at the pre‐ED setting and 177 were intubated in the ED. The overall first‐attempt success rate was 72%, with the rate varying by location, patient, and provider factors—for example, 68% at the pre‐ED setting, 67% for children <2 years, 56% for children with airway‐related anatomical anomalies, and 61% with intubation by a resident physician. Intubation‐related adverse events were observed in 17%, most of which were hypoxemia (14%). Conclusions Based on data from a multicenter prospective study, the overall first‐attempt intubation success rate in pediatric EDs in Japan was 72%, with large variations by location, patient, and provider factors.https://doi.org/10.1002/ams2.798Airway managementchildrencongenital anomalyfirst attempt successintubation |
| spellingShingle | Yusuke Hagiwara Tadahiro Goto Shima Ohnishi Daisuke Miyamoto Yuki Ikeyama Kunihiro Matsunami Kohei Hasegawa the Japanese Emergency Medicine Network Investigators Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study Acute Medicine & Surgery Airway management children congenital anomaly first attempt success intubation |
| title | Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study |
| title_full | Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study |
| title_fullStr | Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study |
| title_full_unstemmed | Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study |
| title_short | Airway management in the pediatric emergency department in Japan: A multicenter prospective observational study |
| title_sort | airway management in the pediatric emergency department in japan a multicenter prospective observational study |
| topic | Airway management children congenital anomaly first attempt success intubation |
| url | https://doi.org/10.1002/ams2.798 |
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