Incidence and Outcomes of Endotracheal Intubation in Patients Presenting With Acute Poisoning to the Emergency Department of a Tertiary Care Center in India: A Prospective Observational Study
- 1Emergency Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
Abstract
Objectives
Endotracheal intubation is a critical airway intervention in severe acute poisoning, but its indications, timing, and outcomes are inconsistently described, and there are limited prospective data from Indian emergency departments (EDs). The primary objective of this prospective observational study was to determine the incidence of endotracheal intubation in adults (≥18 years) presenting with acute poisoning to the ED of AIIMS Rishikesh, Rishikesh, India. The secondary objectives were to (i) identify the clinical indications prompting intubation, (ii) enumerate indications stratified by poison type, (iii) record the timing and duration of intubation among intubated patients, and (iv) compare mortality between intubated and non-intubated patients.
Methods
A prospective observational study was conducted over 15 months (October 2024-December 2025) in the ED of AIIMS Rishikesh. Adult patients (≥18 years) presenting with acute poisoning were enrolled using consecutive sampling. Based on past departmental records, a sample size of 120 patients was estimated. Participants were followed for 28 days through hospital records or telephonic follow-up after discharge.
Results
This study included predominantly young adults with a slight male predominance (51.7%; 62/120), and the majority of poisoning cases were suicidal in nature. Pesticides, particularly organophosphorus (OP) compounds, were the most common poisoning agents, followed by household corrosives. Endotracheal intubation was required in 15.8% (19/120) of patients, with threatened airway due to a reduced Glasgow Coma Scale being the most common indication, followed by respiratory distress and excessive secretions. OP poisoning frequently required intubation due to multiple indications, while paraquat poisoning often required delayed intubation because of progressive respiratory failure. The overall mortality was 9.2% (11/120), with significantly higher mortality among intubated patients. Most deaths were attributed to OP compounds and paraquat poisoning. Male patients had higher rates of intubation and mortality.
Conclusion
This study found that 15.8% of adults with acute poisoning presenting to emergency required endotracheal intubation, with significantly higher mortality among intubated patients. OP compounds and paraquat were the leading causes of intubation and death. Most intubations were performed at presentation, emphasizing the importance of early airway assessment in the emergency while maintaining close monitoring for delayed respiratory deterioration, especially in paraquat poisoning.
Related
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- Trans-cuff budesonide delivery and its effects on endotracheal intubation-induced subglottic injury
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- Early Changes in Optic Nerve Sheath Diameter Associated with Endotracheal Tube Versus Laryngeal Mask Airway in Children Undergoing Elective Surgery Under General Anesthesia: A Prospective Observational Study
- Sociodemographic and Clinical Profile of Homeless Patients Attending the Emergency Department of a Tertiary Care Centre in Rishikesh, Uttarakhand, India: A Prospective Observational Study
BibTeX
@article{ambati2026incidence,
title = {{Incidence and Outcomes of Endotracheal Intubation in Patients Presenting With Acute Poisoning to the Emergency Department of a Tertiary Care Center in India: A Prospective Observational Study}},
author = {Sreevardhan Reddy Ambati and Poonam Arora and Bharat B Bhardwaj and Parampreet Singh and Sarath S Nair and Koushik D},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117325},
url = {https://europepmc.org/article/PMC/PMC13723325},
note = {CC BY},
}
RIS
TY - JOUR
TI - Incidence and Outcomes of Endotracheal Intubation in Patients Presenting With Acute Poisoning to the Emergency Department of a Tertiary Care Center in India: A Prospective Observational Study
AU - Sreevardhan Reddy Ambati
AU - Poonam Arora
AU - Bharat B Bhardwaj
AU - Parampreet Singh
AU - Sarath S Nair
AU - Koushik D
PY - 2026
DA - 2026/10/01
JO - Cureus
DO - 10.7759/cureus.117325
UR - https://europepmc.org/article/PMC/PMC13723325
AB - Objectives Endotracheal intubation is a critical airway intervention in severe acute poisoning, but its indications, timing, and outcomes are inconsistently described, and there are limited prospective data from Indian emergency departments (EDs). The primary objective of this prospective observational study was to determine the incidence of endotracheal intubation in adults (≥18 years) presenting with acute poisoning to the ED of AIIMS Rishikesh, Rishikesh, India. The secondary objectives were to (i) identify the clinical indications prompting intubation, (ii) enumerate indications stratified by poison type, (iii) record the timing and duration of intubation among intubated patients, and (iv) compare mortality between intubated and non-intubated patients. Methods A prospective observational study was conducted over 15 months (October 2024-December 2025) in the ED of AIIMS Rishikesh. Adult patients (≥18 years) presenting with acute poisoning were enrolled using consecutive sampling. Based on past departmental records, a sample size of 120 patients was estimated. Participants were followed for 28 days through hospital records or telephonic follow-up after discharge. Results This study included predominantly young adults with a slight male predominance (51.7%; 62/120), and the majority of poisoning cases were suicidal in nature. Pesticides, particularly organophosphorus (OP) compounds, were the most common poisoning agents, followed by household corrosives. Endotracheal intubation was required in 15.8% (19/120) of patients, with threatened airway due to a reduced Glasgow Coma Scale being the most common indication, followed by respiratory distress and excessive secretions. OP poisoning frequently required intubation due to multiple indications, while paraquat poisoning often required delayed intubation because of progressive respiratory failure. The overall mortality was 9.2% (11/120), with significantly higher mortality among intubated patients. Most deaths were attributed to OP compounds and paraquat poisoning. Male patients had higher rates of intubation and mortality. Conclusion This study found that 15.8% of adults with acute poisoning presenting to emergency required endotracheal intubation, with significantly higher mortality among intubated patients. OP compounds and paraquat were the leading causes of intubation and death. Most intubations were performed at presentation, emphasizing the importance of early airway assessment in the emergency while maintaining close monitoring for delayed respiratory deterioration, especially in paraquat poisoning.
SN - 2168-8184
ER -