@article {Miller1534, author = {Andrew G Miller and Natalie Napolitano and David A Turner and Kyle J Rehder and Akira Nishisaki}, title = {Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study}, volume = {65}, number = {10}, pages = {1534--1540}, year = {2020}, doi = {10.4187/respcare.07667}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs{\textquoteright} intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs.METHODS: A multicenter quality improvement database, the National Emergency Airway Registry for Children (NEAR4KIDS) was queried from 2015 to 2018. We performed a retrospective analysis of prospectively collected data on subject demographics, indication for intubation, difficult airway history and feature presence, provider discipline, medications, and device. Intubation outcomes included first-attempt and overall success rates, adverse events, and oxygen desaturation (ie, \< 80\%). Overall intubation success was defined as intubation achieved in <= 2 attempts.RESULTS: There were 12,056 initial intubation encounters from 46 ICUs, with 109 (0.9\%) first attempts performed by RTs. Nine (20\%) ICUs reported at least one intubation encounter by RTs. The number of intubations performed by RTs at individual centers ranged from 1 to 46 (RT participation rate: 0.3\% to 19.6\%). RTs utilized video laryngoscopy more often than other providers (53.2\% for RTs vs 28.1\% for others, P \< .001). RTs{\textquoteright} first attempt success (RT 60.6\% vs other 69.2\%, P = .051), overall success (RT 76.2 \% vs other 82.4\%, P = .09), and oxygen desaturation \< 80\% (RT 16.5\% vs other 16.9\%, P = .91) were similar to other providers. Adverse events were more commonly reported in intubations by RTs versus by other providers (22.9\% vs 13.8\%, P = .006).CONCLUSIONS: RTs infrequently intubate in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers. RTs{\textquoteright} intubation participation, success, and adverse event rates varied greatly across pediatric ICUs.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/65/10/1534}, eprint = {https://rc.rcjournal.com/content/65/10/1534.full.pdf}, journal = {Respiratory Care} }