ArticleCJEM2026
Successes and failures of ED trauma intubations.
Article in CJEM, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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Authors and funding
14 authors.
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Abstract
purposeApproximately, 12% of trauma activations require intubation and 25% of all emergency department (ED) intubations are in trauma patients. The first-pass success rate in trauma patient intubation is 64-90%. This study aims to explore factors associated with first-pass success and adverse event rates in trauma patients in a Canadian context.
methodsWe conducted a health records and registry review of a cohort of trauma patients requiring intubation at two Level 1 trauma sites in British Columbia (January 2017-March 2022). Primary outcome was first-pass success rate. Secondary outcomes were adverse events rates as well as identifying factors associated with first-pass success and adverse events. Multivariate logistic regression explored associations with key covariates and estimated adjusted odds ratios.
resultsAmong 440 patients, 85% experienced first-pass success and 22% experienced adverse events. DASH-1A rates were 72%. Adjusted logistic regression revealed that video laryngoscopy was positively associated with first-pass success (OR 2.38 CI 1.13-4.99 p = 0.02). Trauma to head, face, or neck was negatively associated with first-pass success (OR 0.09 CI 0.01-0.65, p = 0.02). Intubations by junior residents and higher injury severity scores were associated with an increased odds ratio of adverse events (OR 2.12 CI 1.02-4.42 p = 0.05 and OR 1.04 CI 1.02-1.06 p = 0.001 respectively).
conclusionsOur project is the first to comprehensively report first-pass success, adverse events, intubation operator/equipment, and trauma characteristics for Canadian trauma patients intubated in the ED. Video laryngoscopy was associated with improved first-pass success, while head, face, or neck trauma was associated with reduced first-pass success. Further, intubations by junior residents and extensive injuries were found to be associated with a greater frequency of adverse events. Ongoing quality improvement and trauma-specific intubation training should continue in order to improve first-pass success, reduce adverse events, and address patient-oriented outcomes.
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