Emergency Medicine, Intubation, Intratracheal
Conditions
Keywords
predictive score, difficult intubation
Brief summary
A seven-item simplified score (the MACOCHA score) has been validated to predict difficult tracheal intubation in intensive care unit patients. In the prehospital or in the emergency department settings, no such validated predictive score is available yet. The aim of the present study is to assess the feasibility the quick calculation of the MACOCHA score before emergent intubation, in the prehospital and emergency department contexts.
Detailed description
All patients who will have to undergo emergent tracheal intubation for any reason in the prehospital context or at the emergency department at a single 1100-bed regional and teaching hospital in France, will be included in this observational, prospective study, provided that neither the patient him/herself, if capable, or next-of-kin if present have declined participation. Items of the MACOCHA score will be recorded before intubation by investigators, who are all certified emergency physicians skilled with urgent tracheal intubation. For any intubation procedure, either in the out-of-hospital context or in the Emergency Department, one of these emergency physicians is always present. The feasibility the quick MACOCHA score calculation before urgent intubation will be assessed by the number and percentages of patients for whom all the seven items of the score have been collected.
Interventions
OTHERquestionnaire to be filled in by investigators
A simple seven-item questionnaire will be filled in by the investigator before performing urgent tracheal intubation. This intubation, which will be performed as done in routine care, does not constitute a study specific intervention
Sponsors
Centre Hospitalier Régional d'Orléans
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient ≥ 18 yrs * Patient who have to undergo rapid sequence tracheal intubation as judged by the Emergency Physician
Exclusion criteria
* Pregnancy * Cardiac arrest of any cause as the indication for intubation * Patient or next-of-kin declining participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number of missing items of the MACOCHA score | 5 minutes | The MACOCHA score is a predictive score of difficult intubation in intensive care to anticipate and prepare the appropriate equipment, possibly use an alternative strategy of intubation and call for help to reduce the risk of morbidity and mortality. The MACOCHA score involves various simple assessment items: a Mallampati III or IV, a sleep apnea syndrome, a decrease in cervical mobility, a mouth opening \<3cm, a coma defined by a Glasgow score \<8, severe hypoxemia, and if the practitioner is not anesthetist. Missing items are defined as those for which relevant information cannot be collected before intubation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adverse events | 30 min | occurrence of any adverse event during and 30 minutes after intubation |
Countries
France
Outcome results
None listed