The Value of Not Intubating Comatose Patients With Acute Poisoning

Imagine if a new multicenter, randomized trial of a pharmaceutical drug found that for every 3 patients treated on presentation to the hospital with a common severe illness, one intubation and an intensive care unit (ICU) admission were prevented. This would be an instant blockbuster drug. Insurers would scramble to reimburse it, and guidelines and quality metrics would be established to facilitate implementation. In the setting of worsening hospital and ICU strain globally, health systems would work rapidly to implement pathways for using this new therapy. For reference, the RECOVERY trial testing the use of dexamethasone in hospitalized patients with COVID-19, cited more than 2500 times since publication 3 years ago, reduced the need for intubation for 1 in every 50 patients.