Estimates of sedation in patients undergoing endotracheal intubation in US EDs
The American Journal of Emergency Medicine, 07/05/2012
Weingart GS et al. – Less than one–half of patients undergoing endotracheal intubation (ETI) in the emergency department (ED) receive sedative drugs while in the ED. These findings are congruent with prior smaller studies from single academic centers.Methods
- The authors performed a retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009.
- They identified all ED patient visits with ETI.
- Using the multiple probability sampling design of the National Hospital Ambulatory Medical Care Survey, they estimated the proportion of ETI patients receiving pharmacologic sedation, defined as benzodiazepines, opiates, or other sedative agents (propofol, ketamine, etc).
- They compared patients receiving sedative drugs with those who did not using descriptive statistics and univariable logistic regression.
- During the 4–year study period, 1,071,000 patients (95% confidence interval [CI],839,000–1,303,000) underwent ETI in the ED.
- Of intubated patients, 46.4% (95% CI, 40.2%–52.7%) received sedative drugs, most commonly benzodiazepines (67.9%).
- Of patients who survived to hospital admission, 57.4% (95% CI, 48.7%–65.7%) received sedative drugs.
- Patients were less likely to receive sedation if they were diagnosed with circulatory or cardiac disease (odds ratio, 0.51; P=.026).
- Use of sedative drugs was not associated with patient age, sex, race, geographic location, or extended ED length of stay (>2hours).