Medicina de Emergência: Acesso Aberto
Acesso livre

Abstrato

Practice of Extubation in the Emergency Department: A Cross-Sectional Observational Study

Mohammed Yousuf Iqbal, Emad A Abdulkarim, Sarah Albassam, Fandi Alanazi

Background: The practice of extubation is unpopular among emergency departments (EDs) worldwide, owing to numerous factors including lack of professional training required for the procedure. In addition, data on the safety of this procedure remains unavailable.

Methods: This study reviewed extubation cases in the ED of the King Fahd Hospital, Madina, with the objective of determining the safety of this procedure. Clinico-demographic details of 50 patients, who underwent extubation in the ED, over a period of 4 years, were collected manually from the hospital records and analyzed.

Results: The median patient age was 30 years, and 78% patients were male. Underlying causes included blunt trauma (72%) blunt trauma and medical experience (26%). Of the 50 patients, 20 were intubated before arrival to the ED; 72% were intubated because of decreased levels of consciousness, 20% because of hypoxia, and 8% because of combative behavior. Of the 50 patients that underwent extubation, only 2 (4%) had to undergo unplanned reintubation, while 6 (12%) were scheduled for orthopedic and neurosurgical procedures. The ICU admission rate post extubation was 16% as 8 patients’ required ICU admission, whereas the remaining 42 patients (84%) were transferred to the wards.

Conclusion: This study indicates that extubation in the ED is safe if the clinical condition necessitating airway control has resolved during hospital stay. Further studies are required to assess the impact of extubation on duration of hospital stay and to establish whether the practice of extubation allows for more a judicial use of hospital resources.