RT Journal Article SR Electronic T1 Emergency Department Airway Management for Status Asthmaticus With Respiratory Failure JF Respiratory Care FD American Association for Respiratory Care SP 1904 OP 1907 DO 10.4187/respcare.07723 VO 65 IS 12 A1 Haley T Godwin A1 Megan L Fix A1 Olesya Baker A1 Troy Madsen A1 Ron M Walls A1 Calvin A Brown III YR 2020 UL http://rc.rcjournal.com/content/65/12/1904.abstract AB BACKGROUND: Data are limited regarding current practice and outcomes for emergency department airway management in status asthmaticus. This paper describes the foremost methods and outcomes of airway management in patients in the emergency department who required intubation for status asthmaticus.METHODS: We analyzed all intubations with a primary indication of asthma over a 3-y period (January 1, 2016 to December 31, 2018) using the National Emergency Airway Registry (NEAR), a 25-center, prospective, observational registry of emergency department intubations. We report the incidence of intubations for asthma, methods and medications used, devices used, peri-intubation adverse events, and intubation success and failures using univariate descriptive statistics and cluster-adjusted incidence with 95% CI.RESULTS: A total of 19,071 encounters were recorded during the study period, with 14,517 patients intubated for medical indications. Of those, 173 (1.2%, 95% CI 0.9-1.6) were intubated for asthma. The first-attempt success rate was 90.8% (95% CI 81.9–95.5), and overall intubation success was 100%. Compared to the medical registry as a whole, patients with asthma were more likely to undergo rapid-sequence intubation (96.5% [95% CI 92.9–98.3] vs 80.8% [95% CI 75.1–82.5]), preoxygenation with bi-level positive airway pressure (BPAP) (62.9% [95% CI 49.6–74.6] vs 13.5% (95% CI 10.4–16.9]), and induction with ketamine (51.8% [95% CI 30.6–71.4] vs 11.6% [95% CI 7.6–16.8]). The adverse event rate in the patients with asthma was 12.14% (95% CI 8.1–17.9) compared to 11.93% (95% CI 9.79–14.12) in the medical registry.CONCLUSIONS: Status asthmaticus accounted for about 1% of emergent medical intubations. The majority of patients were intubated using rapid-sequence intubation after preoxygenation with BPAP and induction with ketamine, with the latter 2 practices being much more common for emergent intubations for status asthmaticus than for other medical indications.