Videographic Assessment of Pediatric Endotracheal Intubation in the Covid-19 Era
A Report From the Videography in Pediatric Resuscitation Collaborative (VIPER) Presented by Dr. Tara NeubrandMarion Ruth Sills, MD, MPH | Department of Pediatrics, School of Medicine Nov 13, 2020
The study's objective was to use video review to compare intubator training level, first-attempt endotracheal intubation (ETI) success and presence of hypoxia during ETI attempts in the pediatric emergency department in the pre-COVID and COVID era.
In a retrospective case series of video-recordings of ETIs at the four tertiary care pediatric emergency departments comprising the VIPER Collaborative, the investigators evaluated video-recordings for first-attempt intubation success and hypoxia, defined as SpO2 <90%.
Data was compared before (PRE) and after (POST) implementation of COVID-19 airway protocols, which each emergency department adopted in March 2020. Between 1/1/2019 and 6/1/2020, a total of 272 patients underwent ETI (239 PRE, 33 POST). Overall first attempt success was 65% in PRE and 85% in POST (p=0.02). Hypoxia was noted in 15% of PRE patients and in 12% of POST patients. Analysis of the training level of the intubator was notable for a significant increase in the number of intubations performed by anesthesiologists. In multivariate analysis controlling for intubator background, the POST phase was associated with greater first attempt success (AOR 2.4, 95% CI 1.6 – 3.7). Slide-set: RESS2020224 Neubrand Presentation