Patients with active hemorrhage benefit when clinicians prioritize volume resuscitation before intubation and limit ED airway use.
In a cohort study of patients with active hemorrhage, endotracheal intubation in the emergency department was associated with higher mortality rates, more frequent ICU admissions, and a greater need for blood transfusion compared with intubation in the operating room .Researchers conducted a nationwide, retrospective cohort analysis using data from the Israel National Trauma Registry between 2013 and 2023.
A total of 1527 patients who required transfer to the OR for hemorrhage control surgery within 90 minutes of ED arrival were included. A total of 279 participants underwent endotracheal intubation in the ED and 1248 were intubated upon arrival in the OR. Indications for immediate intubation in the ED included having a Glasgow Coma Scale score 14, and secondary outcomes included blood transfusion requirements and ICU admission following hemorrhage control procedures.
Patients were followed up until discharge from their respective trauma care centers, and potential confounders included age, sex, systolic blood pressure on admission, ISS, and blunt vs penetrating trauma.Among the patients intubated in the ED, 44.1% were hospitalized for 14 or more days, whereas 19.
TBI Traumatic Brain Injury (TBI) Intubation Intubation Care Endotracheal Intubation Endotracheal Tube Care Endotracheal Tube Management Hemorrhage Bleeding Blood Transfusion Blood Transfusion Airway Airway Management Management Of The Airway Wound Management Wound Care Injury Resuscitation Hospitals Glasgow Coma Scale
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