Characteristics, Practice Patterns, and Outcomes of Emergency Department Intubation for Sepsis: An ANZEDAR Registry Study.

objectiveSepsis is a leading cause of critical illness in Australia and New Zealand, with over 75% of admissions occurring through emergency departments. This study aimed to characterise the demographics, process of care, pharmacology, and peri-intubation adverse events of sepsis intubations using a prospective Australasian registry.

methodsA retrospective analysis of prospectively collected data from the Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) was performed across 79 hospitals between January 2010 and March 2026. Intubations performed for a primary indication of sepsis were identified. A paediatric subgroup analysis was performed stratified by age band. Statistical comparisons used Mann-Whitney U tests for continuous variables and chi-square or Fisher's exact tests for categorical variables.

resultsOf 11,289 registry intubations, 280 (2.5%) were performed for sepsis. Paediatric patients with confirmed age under 16 years comprised 30 of 280 sepsis intubations (10.7%). Adults were older, more haemodynamically compromised, and had longer triage to intubation times than non-sepsis patients across all age groups. Laryngoscopic views and first-pass success were comparable between sepsis and non-sepsis groups. Haemodynamic complications occurred in 27.9% of sepsis intubations and peri-intubation cardiac arrest in 4.6%. Waveform capnography was used less frequently in sepsis versus non-sepsis groups (87.5% vs. 94.1%; p < 0.001).

conclusionEmergency department sepsis intubation is associated with high rates of haemodynamic complications despite similar laryngoscopic views and first-pass success rates. Low waveform capnography use in infant sepsis represents a potential patient safety concern. These findings support targeted interventions.