Introduction: Emergency medicine physicians are responsible for acute management of airway emergencies. Anticipation of potentially difficult airways is a crucial skill. While there are several tools used to predict challenging airways, none has proven universally effective. We sought to evaluate patient demographics associated with longer first pass intubation times. Methods: We performed a retrospective analysis at a single urban academic hospital. Videos of intubations utilizing video laryngoscopy were recorded and independently reviewed by two emergency medicine physicians. Predetermined variables for analysis included time to cord view and time for intubation. Reviewed videos were matched with the patient’s electronic medical records to obtain demographic information including - age, sex, race/ethnicity, comorbidities, and BMI. Intubation times were compared for different patient demographics. Results: Among 113 videos viewed for endotracheal intubation, 59 were matched to demographic information in the electronic hospital record. Mean age was 61.2 years (SD 18.1) and 35 were male. Racial/ethnic distribution: 45 Black/African-American (76.3%), 10 White (16.9%), 4 Other (6.8%). Medical comorbidities included hypertension 45.8% (n=27), diabetes mellitus 30.5% (n=18), COPD 20.3% (n=12), CAD in 16.9% (n=10), OSA in 3.4% (n=2), Asthma in 1.7% (n=1), ESRD on HD in 3.4% (n=2), and ESRD w/ no HD in 1.7% (n=1). The mean body mass index (BMI) was 28.8 (SD 10.5). Median time to vocal cord visualization was 9 seconds (18 - 39 years), 6 seconds (40 - 65 years), and 6 seconds (over 65 years). Median time to intubation was 39 seconds (18 - 39 years), 25 seconds (40 - 65), and 24 seconds (over 65 years). There was no significant difference between intubation time based on age, race, or patient age. In addition, there was no association between BMI and time to intubation (r = 0.04) or time to vocal cord visualization (r = –0.06). Conclusions: Preliminary results suggest demographic factors such a sex, age, BMI, are not strongly associated with chord visualization or time to intubation in our cohort. This may suggest demographic factors alone are not enough to predict a successful procedure, and future studies should focus on additional contributors crucial to successful outcomes.
Fakunle et al. (Sun,) studied this question.