Continuous pulse oximetry during emergency endotracheal intubation

Abstract

Study objective: To determine whether continuous pulse oximetry improves the recognition and management of hypoxemia during emergency endotracheal intubation.

Design: A prospective, serial 14-month study.

Setting: Emergency department, Level I trauma center.

Type of participants: All adult patients requiring emergency intubation for whom data collection would not compromise patient care.

Interventions: All samples were obtained from a finger site at a five-second sampling interval and stored in computer memory. Patients were intubated by the nasotracheal or orotracheal route.

Measurements and main results: One hundred ninety-one consecutive adult patients qualified for the study and 211 intubation attempts were analyzed. Hypoxemia (O2 saturation, less than 90%) occurred during an intubation attempt in 30 of 111 nonmonitored versus 15 of 100 monitored attempts (P < .05), and the duration of severe hypoxemia (O2 saturation, less than 85%) was significantly greater for nonmonitored attempts (P < .05).

Conclusion: Continuous pulse oximetry monitoring reduces the frequency and duration of hypoxemia associated with emergency intubation attempts.