Estimate the success rate of intubation in the first attempt based on the HEAVEN criteria

Abstract

HEAVEN criteria are derived from EMS patients and may be a practical and useful tool for airway emergency management. The aim of this study was to evaluate the predictive value of the HEVEAN criterion in assessing the difficulty of intubation in patients referred to the hospital emergency department and indicating intubation in a rapid sequential manner. Methods: In this cross-sectional study, patients who had referred to the emergency department of Imam Reza Hospital and for any reason needed intubation by rapid intubation (RSI) were included in the study. Patients who entered the emergency room with cardiorespiratory arrest or required intubation in the form of CRUSH were excluded from the study. LEMON was calculated for each patient and whether or not intubation was difficult was determined based on the LEMON criterion. Then, for each patient, the HEVEAN criterion was calculated and the patient was intubated. If the first attempt at intubation was made, it was declared successful, but if it was not successful the first time, and the next time the intubation took place or the alternative was used, it was declared unsuccessful. Results: In this study, in which 239 people were included, in examining the age distribution of patients by Kolmogorov-Semirinov statistical method, the normal distribution does not follow, considering that having 3 or more positive criteria in the HEAVEN criterion leads to difficulty in Intubation and its failure will, at this point, have a sensitivity of 75% and specificity of 71.69%. Considering that having 2 or more positive criteria in LEMON criterion will lead to difficulty in intubation and its failure, at this point, the sensitivity will be equal to 100% and the specificity will be equal to 72.15%.