title: Pediatric endotracheal intubations for airway management in the emergency department.
abstract: OBJECTIVE
  The objective of this study was to determine indications, type of medications used, and immediate complications of pediatric endotracheal intubations in the emergency department.
  
  
  METHODS
  A retrospective chart review was done on all pediatric patients (0-14 years old) who required endotracheal (ET) intubation for airway management in the Department of Emergency Medicine at Aga Khan University Hospital from January to December 2009. Data were collected on a preformed questionnaire for age, sex, indications, drugs used, and complications of pediatric ET intubations done in the emergency department. Dead-on-arrival patients and those intubated elsewhere were excluded.
  
  
  RESULTS
  A total of 83 pediatric intubations were done during the study period. Indications for ET intubations were respiratory failure in 51 (61%), unresponsiveness in 18 (22%), cardiac arrest in 8 (10%), and trauma in 6 cases (7%). Comorbid conditions were present in 28 (34%). Of 83 ET intubations, drugs were used in 48 cases (58%). Both sedation and neuromuscular blockade were used in 42 cases (51%), 4 cases (5%) received sedation only, and 2 cases (2%) received relaxation without sedation, and in 35 cases (42%), intubation was done without drugs. Drugs used for sedation/induction were ketamine in 22 (26%), midazolam in 14 (17%), propofol in 7 (8%), and etomidate in 3 cases (4%). Neuromuscular blockades used were rocuronium in 27 cases (32%), succinylcholine in 11 cases (13.5%), and atracurium in 5 cases (6%). Complications were noted in 16 cases (19%).
  
  
  CONCLUSIONS
  Respiratory failure was found to be the main presenting complaint. Drugs for sedation and relaxation to facilitate ET intubation were underused.
authors.affiliation: Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan. surraiya.bano@aku.edu
authors.forename: Surraiya
authors.initials: S
authors.lastname: Bano
authors.forename: Saleem
authors.initials: S
authors.lastname: Akhtar
authors.forename: Nukhba
authors.initials: N
authors.lastname: Zia
authors.forename: Uzma Rahim
authors.initials: UR
authors.lastname: Khan
authors.forename: Anwar-ul
authors.initials: AU
authors.lastname: Haq
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires