Skip to main content

Post-intubation Management

  • Chapter
  • First Online:
Pre-Hospital Anesthesia Handbook

Abstract

The quality of care delivered after intubation and during transfer to hospital may have as much influence on outcome as the intubation itself. Experience from intrahospital transfers suggests that unexpected problems or complications occur during 62–68% of transfers (Lovell et al. 2001) (Papson et al. 2007). Critical or life-threatening incidents occurred in nearly 9%. In the prehospital environment the incidence of complications can be expected to be higher as the environment is often less controlled and the patient more unstable (intrahospital transfers usually only take place if patients are relatively stable). Lovel commented that many of the difficulties were preventable with adequate pretransport communication and planning.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 29.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bhavani-Shankar K, Moseley H, Kumar AY, Delph Y (1992) End-tidal carbon dioxide. Can J Anaesth 39:617–632

    Article  PubMed  CAS  Google Scholar 

  • Cardman E, Friedman D (1997) Further studies of manually operated self-inflating resuscitation bags. Anesth Anal 56:202–206

    Google Scholar 

  • Cooper DJ, Myles P, McDermott FT, Murray LJ, Laidlaw J, Cooper G, Tremayne AB, Bernard SS, Ponsford J (2004) Pre-hospital hypertonic saline solution. JAMA 291:1350–1357

    Article  PubMed  CAS  Google Scholar 

  • Falk JL (1993) End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. Advances in anaesthesia. Mosby-Yearbook, St. Louis, pp 275–288

    Google Scholar 

  • Gerais HW, Eberele B, Konietzke D, Hennes HJ, Dick W (1987) Comparison of blood gases of ventilated patients during transport. Crit Care Med 15:761–763

    Article  Google Scholar 

  • Greaves I, Porter KM, Revell MP (2002) Fluid resuscitation in pre-hospital trauma care: a consensus view. J R Coll Surg Edinb 47:451–457

    PubMed  CAS  Google Scholar 

  • Helm M, Schuster R, Hauke J, Lampl L (2003) Tight control of pre-hospital ventilation by capnography in major trauma victims. Br J Anaesth 90:327–332

    Article  PubMed  CAS  Google Scholar 

  • Jameson PPM, Lawler PG (2000) Transfer of critically ill patients in the Northern region. Anaesthesia 55:489

    Article  PubMed  CAS  Google Scholar 

  • Lovell MA, Mudaliar MY, Klineberg PL (2001) Intrahospital transport of critically ill patients: complications and difficulties. Anaesth Intens Care 29:400–405

    CAS  Google Scholar 

  • Papson JP, Russell KL, Taylor DM (2007) Unexpected events during the intrahospital transport of critically ill patients. Acad Emerg Med 14:574–577

    Article  PubMed  Google Scholar 

  • Patterson H (2004) Emergency department intubation of trauma patients with undiagnosed spinal injury. Emerg Med J 21:302–305

    Article  PubMed  CAS  Google Scholar 

  • Seegobin RD, van Hasselt GL (1984) Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed) 288:965–968

    Article  CAS  Google Scholar 

  • Signorini D, Andrews P, Jones P et al (1999) Predicting survival using simple clinical variables: a study in traumatic brain injury. J Neurol Neurosurg Psychiatr 66:20–25

    Article  PubMed  CAS  Google Scholar 

  • Uusaro A, Parviainen I, Takala J, Ruokonen E (2002) Safe long-distance interhospital ground transfer of critically ill patients with acute severe unstable respiratory and circulatory failure. Intens Care Med 28:1122–1125

    Article  Google Scholar 

  • Vickery D (2001) The use of the spinal board after the pre-hospital phase of trauma management. Emerg Med J 18:51–54

    Article  PubMed  CAS  Google Scholar 

  • Weiss M et al (2006) Tracheal tube-tip displacement in children during head-neck movement-a radiological assessment. Br J Anaesth 96:486–491

    Article  PubMed  CAS  Google Scholar 

  • Yap SJ, Morris RW, Pybus DA (1994) Alterations in endotracheal tube position during general anaesthesia. Anaesth Intens Care 22:586–588

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer London Limited

About this chapter

Cite this chapter

Griffiths, A., Lowes, T., Henning, J. (2010). Post-intubation Management. In: Pre-Hospital Anesthesia Handbook. Springer, London. https://doi.org/10.1007/978-1-84996-159-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-84996-159-2_4

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-158-5

  • Online ISBN: 978-1-84996-159-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics