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Effective Out-of-Operating Room Airway Management for Physicians Not Traditionally Trained in Airway Management
  1. Chad S. Kessler, MD*†‡,
  2. Jenny M. Tristano, MD†‡,
  3. Mary Ann Dignan, MS, RN, CNS, APN§,
  4. Hui Xie, PhD,
  5. Leonard A. Stallings, MD,
  6. Ronald F. Albrecht II, MD**††
  1. From the *Department of Emergency Medicine, Jesse Brown VA Medical Center; Departments of †Internal Medicine and ‡Emergency Medicine, University of Illinois–Chicago; §Intensive Care Unit, Jesse Brown VA Medical Center; and ∥Center for Clinical and Translational Science, University of Illinois–Chicago, Chicago; ¶Departments of Internal Medicine and Emergency Medicine, East Carolina University Brody School of Medicine; and **Department of Anesthesiology, University of Illinois–Chicago; and ††Anesthesiology Service, Jesse Brown VA Medical Center, Chicago, IL.
  1. Received April 23, 2011, and in revised form July 27, 2011.
  2. Accepted for publication July 27, 2011.
  3. Reprints: Chad S. Kessler, MD, Jesse Brown VA Medical Center, 820 S Damen Ave, M/C 111 Emergency Medicine, Chicago, IL 60612. E-mail: Chad.Kessler{at}


Background There is a dearth of literature about the safety and practicality of intubation performed by an internal medicine (IM) or any other nonanesthesia, nonemergency physician.

Objectives The objectives of the study were to describe abbreviated airway management training guidelines for IM physicians staffing the emergency department and to compare the success rates between intubations performed by anesthesia and IM physicians, respectively.

Methods In this study, 272 consecutive out-of-operating room intubations performed by anesthesia and IM physicians were evaluated after creating and implementing an abbreviated intubation training protocol.

Results Of 165 intubations attempted by IM physicians and 107 intubations attempted by the anesthesia service, the rates of successful intubation were 93% and 99%, respectively (P = 0.02). There were no other statistically significant differences in outcomes.

Conclusions Procedurally oriented IM fellows could provide a temporary solution to hospitals that currently do not have the resources to provide full-time, in-house anesthesiology or emergency physicians for management of the emergent airway.

Key Words
  • endotracheal intubation
  • training
  • emergency department
  • anesthesia

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