Factors associated with oxyhemoglobin desaturation during rapid sequence intubation in a pediatric emergency department: findings from multivariable analyses of video review data

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Andrea S RinderknechtBenjamin T Kerrey

Abstract

In a video-based study of rapid sequence intubation (RSI) in a pediatric emergency department (PED), 33% of children experienced oxyhemoglobin desaturation (SpO2 < 90%). To inform targeted improvement interventions, we planned multivariable analyses to identify patient and process variables (including time-based data around performance of key RSI process elements uniquely available from video review) associated with desaturation during pediatric RSI. These were planned analyses of data collected during a retrospective, video-based study of RSI in a high-volume, academic PED. For variables with plausible associations with desaturation, multiple logistic regression and generalized estimating equations were used to identify those characteristics independently associated with desaturation at both the patient and the attempt levels. The authors analyzed video data from 114 patients undergoing RSI over 12 months. Desaturation was more common in patients 24 months of age and younger (59%) than in patients older than 24 months of age (10%). Variables associated with desaturation in patients 24 months of age and younger were duration of attempts (both individual and cumulative), the occurrence of esophageal intubation, a respiratory ind...Continue Reading

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Citations

Dec 29, 2015·The American Journal of Emergency Medicine·Michael J MiescierDouglas S Nelson
May 22, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Matthew A EisenbergJoshua Nagler
Dec 16, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Andrea S RinderknechtMatthew R Mittiga
Jan 24, 2017·Annals of Emergency Medicine·Brian E Driver, John W McGill
Dec 2, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sarah K SchmidtHalden F Scott
Aug 11, 2018·Academic Medicine : Journal of the Association of American Medical Colleges·Kelsey A MillerJoshua Nagler
May 26, 2018·Pediatric Emergency Care·Brad SobolewskiBenjamin T Kerrey
Sep 9, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Preston N DeanAndrew J Lautz
May 12, 2020·Disaster Medicine and Public Health Preparedness·Maybelle KouUNKNOWN Best Pharmaceuticals for Children Act – Pediatric Trials Network
Oct 17, 2020·Pediatric Quality & Safety·Berkeley L BennettSandra P Spencer
Nov 9, 2020·Annals of Emergency Medicine·Sage R MyersAaron J Donoghue
Jan 5, 2021·Journal of the American College of Emergency Physicians Open·Matt HansenRob Walker
Mar 8, 2021·Anaesthesia Critical Care & Pain Medicine·Fanny AyanmaneshSouhayl Dahmani

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