Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review
Objectives: Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2022-06-01
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| Series: | Canadian Journal of Respiratory Therapy |
| Subjects: | |
| Online Access: | https://www.cjrt.ca/wp-content/uploads/cjrt-2022-015.pdf |
| _version_ | 1828103883480629248 |
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| author | Mika L. Nonoyama Vinay Kukreti Efrosini Papaconstantinou Natascha Kozlowski Sarah Tsimelkas |
| author_facet | Mika L. Nonoyama Vinay Kukreti Efrosini Papaconstantinou Natascha Kozlowski Sarah Tsimelkas |
| author_sort | Mika L. Nonoyama |
| collection | DOAJ |
| description | Objectives: Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution.
Methods: This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children
(SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were
intubation first-pass success (FPS) and AEs secondary to intubation.
Results: Patients (n = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4–14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (n = 25, 23%) or anaesthetists (n = 12, 11%), versus all other providers (paramedic n = 13 (12%), ED physician n = 37 (34%), respiratory therapist n = 20 (18%), transfer team n = 2 (2%)). The proportion of AEs was 24 (19.8%, n = 21 minor, n = 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29–3.8) days.
Conclusions: Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations’ unique practice cultures, including training programs. |
| first_indexed | 2024-04-11T09:33:41Z |
| format | Article |
| id | doaj.art-c6cec3f332114463a92ee7b37be42b1e |
| institution | Directory Open Access Journal |
| issn | 2368-6820 |
| language | English |
| last_indexed | 2024-04-11T09:33:41Z |
| publishDate | 2022-06-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj.art-c6cec3f332114463a92ee7b37be42b1e2022-12-22T04:31:47ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202022-06-0158697610.29390/cjrt-2022-015Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart reviewMika L. NonoyamaVinay KukretiEfrosini PapaconstantinouNatascha KozlowskiSarah TsimelkasObjectives: Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution. Methods: This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children (SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were intubation first-pass success (FPS) and AEs secondary to intubation. Results: Patients (n = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4–14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (n = 25, 23%) or anaesthetists (n = 12, 11%), versus all other providers (paramedic n = 13 (12%), ED physician n = 37 (34%), respiratory therapist n = 20 (18%), transfer team n = 2 (2%)). The proportion of AEs was 24 (19.8%, n = 21 minor, n = 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29–3.8) days. Conclusions: Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations’ unique practice cultures, including training programs.https://www.cjrt.ca/wp-content/uploads/cjrt-2022-015.pdfintubationpediatricsemergency servicehospitalretrospective studiespatient outcome assessmentcommunity |
| spellingShingle | Mika L. Nonoyama Vinay Kukreti Efrosini Papaconstantinou Natascha Kozlowski Sarah Tsimelkas Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review Canadian Journal of Respiratory Therapy intubation pediatrics emergency service hospital retrospective studies patient outcome assessment community |
| title | Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review |
| title_full | Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review |
| title_fullStr | Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review |
| title_full_unstemmed | Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review |
| title_short | Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review |
| title_sort | outcomes and follow up for children intubated in an adult based community hospital system a retrospective chart review |
| topic | intubation pediatrics emergency service hospital retrospective studies patient outcome assessment community |
| url | https://www.cjrt.ca/wp-content/uploads/cjrt-2022-015.pdf |
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