How Often Do We Actually Intubate in the Emergency Department?

August 27, 2019

Written by Clay Smith

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The average emergency physician does about 10 endotracheal intubations (ETI) per year. However, about one quarter of physicians perform <5 per year.

Why does this matter?
Skill decay is real. If we do a procedure infrequently, we may not perform it optimally. Tomorrow, we will discuss the annual number of intubations needed to maintain proficiency, but the first step is to determine how often we are performing ETI in the ED.

Do we walk the walk or just talk the talk?
This was a database from US Acute Care Solutions of 135 EDs in 19 states over several years. They looked at almost 54,000 intubations by over 2,100 physicians. The median number of ETIs per year was 10. Five percent performed none, and 24% performed < 5 per year. Just 11% of these facilities were trauma centers. So, this may not be generalizable to some higher acuity ED settings. Tomorrow’s study looks at how many ETIs we need to maintain proficiency at this procedure.

Source
Procedural Experience With Intubation: Results From a National Emergency Medicine Group. Ann Emerg Med. 2019 Jun 24. pii: S0196-0644(19)30348-8. doi: 10.1016/j.annemergmed.2019.04.025. [Epub ahead of print]

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Reviewed by Thomas Davis