Evidence map›Paper›PMID 39226793›Full record

ArticleThe American journal of emergency medicine2024

Characterizing emergency department surgical airway placement in the setting of trauma.

Amy R Krepps, David J Douin, Julie M Winkle, Franklin L Wright, Andrew D Fisher, Michael D April, Steven G Schauer

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amy R KreppsDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.
David J DouinDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.
Julie M WinkleDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Franklin L WrightDepartment of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Andrew D FisherDepartment of Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Michael D April14(th) Field Hospital, Fort Stewart, GA, USA; Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Steven G SchauerDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA; Center for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: steven.schauer@cuanschutz.edu.

Funding

Restoring Endothelial Function After Traumatic Injury to Reduce ARDS and Multi-Organ DysfunctionK23HL165107 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI David J. Douin · 2023 to 2026
$759k
NHLBI NIH HHS K23 HL165107
6 · The paper itself

Abstract

introductionAirway management is a key intervention during the resuscitation of critically ill trauma patients. Emergency surgical airway (ESA) placement is taught as a backup option when endotracheal intubation (ETI) fails. We sought to (1) describe the incidence of the emergency department (ED) ESA, (2) compare ESA versus ETI-only recipients, and (3) determine which factors were associated with receipt of an ESA.

methodsWe searched within the Trauma Quality Improvement Program datasets from 2017 to 2022 for all emergency department surgical airway placement and/or endotracheal intubations recipients. We compared ESA versus ETI-only recipients.

resultsFrom 2017 to 2022, there were 6,477,759 within the datasets, of which 238,128 met inclusion for this analysis. Within that, there were 236,292 ETIs, 2264 ESAs, with 428 (<1 %) having documentation of both. Of the ESAs performed, there were 82 documented in children <15 years of age with the youngest being 1 year of age. The ETI-only group had a lower proportion serious injuries to the head/neck (52 % versus 59 %), face (2 % versus 8 %), and skin (3 % versus 6 %). However, the ETI-only group had a higher proportion of serious injuries to the abdomen (15 % versus 9 %) and the extremities (19 % versus 12 %). Survival at 24-h was higher in the ETI-only group (83 % versus 76 %) as well as survival to discharge (70 % versus 67 %). In the subanaysis of children <15 years (n = 82), 34 % occurred in the 1-4 years age group, 35 % in the 5-9 years age group, and 30 % in the 10-14 years age group. In our multivariable logistic regression analysis, serious injuries to the head/neck (odds ratio [OR] 1.37, 95 % CI 1.23-1.54), face (OR 3.41, 2.83-4.11), thorax (OR 1.19, 1.06-1.33), and skin (OR 1.53, 1.15-2.05) were all associated with receipt of cricothyrotomy. Firearm (OR 3.62, 3.18-4.12), stabbing (2.85, 2.09-3.89), and other (OR 2.85, 2.09-3.89) were associated with receipt of ESA when using collision as the reference variable.

conclusionsESA placement is a rarely performed procedure but frequently used as a primary airway intervention in this dataset. Penetrating mechanisms, and injuries to face were most associated with ESA placement. Our findings reinforce the need to maintain this critical airway skill for trauma management.

Indexed as

Airway ManagementEmergency Service, HospitalIntubation, IntratrachealWounds and InjuriesAdolescentAdultAgedChildChild, PreschoolFemaleHumansInfantMaleMiddle AgedQuality ImprovementRetrospective StudiesAirwayCricothyrotomyEmergencyIntubationSurgicalTrauma

Identifiers

PMID39226793
PMCPMC11898114

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.