Model of Wang et al for Predicting Failure of Out-of-Hospital Endotracheal Intubation in an Adult

Description

Wang et al developed a model for predicting the risk of failure for out-of-hospital intubation in an adult. This can help identify patients who may require additional care when attempting a prehospital intubation. The authors are from the University of Pittsburgh and Geisinger Health System (Danville, Pennsylvania).

NOTE: Factors listed by the authors as affecting intubation are listed in Chapter 31.

Parameters:

(1) clenched jaw or trismus

(2) ability to pass the endotracheal (ET) tube through the vocal cords

(3) ability to visualize the vocal cords

(4) gag reflex

(5) intravenous (IV) access timing relative to endotracheal intubation attempt

(6) body weight (after Table 1, page 720)

(7) ECG monitoring relative to endotracheal intubation attempt

Parameter	Finding	Points
clenched jaw/trismus	absent	0
	present	1
ability to pass ET tube through vocal cords	able	0
	unable	1
ability to visualize vocal cords	able	0
	unable	1
gag reflex	absent	0
	present (intact)	1
IV access	after ET intubation	0
	before ET intubation	1
body weight	< 100 pounds	1
	100 - 149 pounds	2
	150 - 199 pounds	3
	200 - 249 pounds	4
	250 - 299 pounds	5
	300 - 349 pounds	6
	350 - 399 pounds	7
	>= 400 pounds	8
ECG monitoring	after ET intubation	0
	before ET intubation	1

X =

= (2.274 * (points for clenched jaw/trismus)) + (2.0351 * (points for ability to pass ET tube)) + (2.0331 * (points for ability to visualize vocal cords)) + (1.9544 * (points for gag reflex)) + (1.1568 * (points for IV access timing)) + (0.4413 * (points for body weight)) - (1.6168 * (points for ECG monitoring)) - 4.3211

probability of failed intubation =

= 1 / (1 + EXP((-1) * X))

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Model of Wang et al for Predicting Failure of Out-of-Hospital Endotracheal Intubation in an Adult

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