Endotracheal Intubation

CJEM Infographic: Device and Medication Preferences for Endotracheal Intubation in Critically Ill Patients

In Infographics, Medical Concepts by Alvin Chin1 Comment

The second article of the month featured on CanadiEM also comes from the Canadian Journal of Emergency Medicine (CJEM).1 This study aimed to examine the variation and diversity in practice of emergent endotracheal intubation (EETI) in practicing Canadian physicians.  The authors surveyed a large number of emergency medicine (EM) and intensive care unit (ICU) physicians to determine which medications, devices, and backups were chosen for EETI.

Green et al. 1 distributed a survey to ICU and EM physicians using web-based and postal methods. Using a 5-point Likert scale ranging from ‘always’ to ‘never’, physicians were asked to respond as to the medication, device, and backups they would use in three different described scenarios.  The most preferred intubation method was direct laryngoscopy with a Macintosh blade and the most preferred backup was an extra-glottic device. Medication choices by EM physicians varied between patient scenarios while ICU physicians preferred fentanyl in all cases.  Furthermore, EM physicians were more likely to paralyze patients than ICU physicians and the groups preferred succinylcholine and rocuronium respectively.

In summary, while describing the most commonly chosen medications, devices, and backup methods in EM and ICU physicians, the authors also highlighted the wide variation in practice amongst EM and ICU physicians when performing EETI.

Download the infographic as a PDF!

References

1.
Green R, Fergusson D, Turgeon A, et al. Device and Medication Preferences of Canadian Physicians for Emergent Endotracheal Intubation in Critically Ill Patients. CJEM. 2017;19(3):186-197. [PubMed]
Alvin is currently a PGY5 in the FRCP EM program at McMaster University. He serves as Director of Design for CanadiEM and has interests in knowledge translation and health innovation.