Effects of Not Intubating Non-Trauma Patients With Low Glasgow Coma Scale Scores: a Retrospective Study
Journal Title: The Journal of Medicine, Law & Public Health (JMLPH) - Year 2022, Vol 2, Issue 1
Abstract
Background: Endotracheal intubation (EI) is a critical life-saving procedure commonly performed on emergency department (ED) patients who present with altered mental status (AMS). Aims: We aimed to investigate the safety of observing, without EI, patients who present to the ED with decreased levels of consciousness (LOC). Methods: We reviewed the data of all adult ED patients with a Glasgow Coma Scale (GCS) score ≤ 8, during the period between 2012 and 2018, in an academic tertiary care centre. Trauma patients were excluded. The patients were divided into two groups for comparison: those who were intubated and those who were not. Data on mortality, morbidity, and baseline clinical characteristics were collected and analysed. Results: After screening 6334 electronic medical records of patients presenting to the ED with decreased LOC, only 257 patients met the inclusion criteria. 173 (67.3%) patients were intubated, while 84 (32.7%) were not. Among the intubated patients, 165 (95.4%) were intubated early (within two hours of presentation). Mortality, morbidity and length of stay for the intubated group were higher, although the baseline clinical characteristics were the same. Conclusion: It might be safe to observe non-trauma emergency patients with a GCS score ≤ 8 without intubation. However, such decision should be taken carefully, as delayed intubation can be associated with higher mortality and morbidity
Authors and Affiliations
Loui K Alsulimani, Ohoud Baajlan, Khalid Alghamdi, Raghad Alahmadi, Abdullah Bakhsh, Jameel Abualenain
Keywords
Related Articles
- EP ID EP732208
- DOI https://doi.org/10.52609/jmlph.v2i1.41
- Views 65
- Downloads 0
Knowledge and Attitude of Mothers Towards Childhood Vaccination in Taif, Saudi Arabia
Background: Misconceptions and inadequate knowledge about vaccination represent an important barrier against adherence to vaccination schedules. Objectives: To assess the knowledge and attitude of mothers of children...
A critical case commentary on Avon and Wiltshire Mental Health Partnership and North Bristol NHS Trust v WA and DT: Did the judge reach a fair and just decision regarding the capacity and best interest of the person?
Avon and Wiltshire Mental Health Partnership and North Bristol NHS Trust v WA and DT [2020] EWCOP, [2020] 7 WLUK 271: This case critically evaluates the findings on WA’s capacity assessment and best interest decision mad...
Adjudication and Treatment of Narcotic Drug Offenders in Ghana
Narcotic drug trafficking is a criminal and punishable offence in every country the world over. The use of certain narcotic drugs, on the other hand (especially marijuana), has been legalised in some countries, but under...
The Risk of Post-Traumatic Stress Disorder (PTSD) among Frontline Healthcare Workers in Saudi Arabia during the COVID-19 Pandemic: A Cross-sectional Study
Background: Frontline healthcare workers (HCWs) are at risk of developing post-traumatic stress disorder (PTSD) due to the nature of their work and, due to the additional stress and mental fatigue brought on by the COVID...
Magnesium Administration For COPD Exacerbation: A Systematic Review and Meta-analysis
BACKGROUND The role of magnesium in patients with acute chronic obstructive pulmonary disease (COPD) exacerbation remains to be determined. AIM We aim to explore the effect of magnesium on COPD exacerbation, as well a...