Patient safety in emergency airway management and rapid sequence intubation: Metaphorical lessons from skydiving

2003 ◽  
Vol 42 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Richard M. Levitan
Keyword(s):  
Patient Safety ◽  
Airway Management ◽  
Rapid Sequence Intubation ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Rapid Sequence

Airway Management In The Emergency Department

2018 ◽  
Author(s):  
Garrett S. Pacheco ◽  
Bryan Wilson
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Rapid Sequence Intubation ◽  
Intubation Attempt ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Airway Emergency ◽  
Rapid Sequence ◽  
First Pass ◽  
Surgical Airway

Emergency airway management has evolved tremendously since the onset of the specialty’s origin. Over the years, the importance of first-pass success and approach to the difficult airway were the primary challenges faced by emergency physicians. With the advent of video laryngoscopy, the rates of first-pass success continue to increase, and the effect of the anatomically difficult airway has begun to lessen. With advances in tools for airway management, the challenges have shifted to approaching optimal preoxygenation and correction of physiologic disturbances prior to any intubation attempt. This review discusses traditional rapid sequence intubation and advances in the field of emergency airway management.  This review contains 6 figures, 6 tables and 74 references Key words: difficult airway, emergency airway management, preoxygenation, surgical airway

Rapid sequence intubation for pediatric emergency airway management

2002 ◽  
Vol 18 (6) ◽  
pp. 417-423 ◽  
Author(s):  
MARK J. SAGARIN ◽  
VINCENT CHIANG ◽  
JOHN C. SAKLES ◽  
ERIK D. BARTON ◽  
RICHARD E. WOLFE ◽  
...  
Keyword(s):  
Airway Management ◽  
Pediatric Emergency ◽  
Rapid Sequence Intubation ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Rapid Sequence

scholarly journals Emergency airway management in a Singapore centre: A registry study

2021 ◽  
Vol 50 (1) ◽  
pp. 42-51
Author(s):  
Gene Wai Han Chan ◽  
Chew Yian Chai ◽  
Joy Su-Yue Teo ◽  
Calvin Kai En Tjio ◽  
Mui Teng Chua ◽  
...  
Keyword(s):  
Adverse Events ◽  
Airway Management ◽  
Difficult Airway ◽  
Rapid Sequence Induction ◽  
University Hospital ◽  
Rapid Sequence Intubation ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Rapid Sequence ◽  
Medical Indications

ABSTRACT Introduction: Intubations in the emergency department (ED) are often performed immediately without the benefit of pre-selection or the ability to defer. Multicentre observational data provide a framework for understanding emergency airway management but regional practice variation may exist. We aim to describe the intubation indications, prevalence of difficult airway features, peri-intubation adverse events and intubator characteristics in the ED of the National University Hospital, Singapore. Methods: We conducted a prospective observational study over a period of 31 months from 1 March 2016 to 28 September 2018. Information regarding each intubation attempt, such as indications for intubation, airway assessment, intubation techniques used, peri-intubation adverse events, and clinical outcomes, was collected and described. Results: There were 669 patients, with male predominance (67.3%, 450/669) and mean age of 60.9 years (standard deviation [SD] 18.1). Of these, 25.6% were obese or grossly obese and majority were intubated due to medical indications (84.8%, 567/669). Emergency physicians’ initial impression of difficult airway correlated with a higher grade of glottis view on laryngoscopy. First-pass intubation success rate was 86.5%, with hypoxia (11.2%, 75/669) and hypotension (3.7%, 25/669) reported as the two most common adverse events. Majority was rapid sequence intubation (67.3%, 450/669) and the device used was most frequently a video laryngoscope (75.6%, 506/669). More than half of the intubations were performed by postgraduate clinicians in year 5 and above, clinical fellows or attending physicians. Conclusion: In our centre, the majority of emergency intubations were performed for medical indications by senior doctors utilising rapid sequence intubation and video laryngoscopy with good ffirst-attempt success. Keywords: Difficult airway, emergency services, intubation, peri-intubation adverse events, rapid sequence induction

scholarly journals Emergency Airway Management in Patients with COVID-19: A Prospective International Multicenter Cohort Study

2021 ◽  
Author(s):  
Danny J. N. Wong ◽  
Kariem El-Boghdadly ◽  
Ruth Owen ◽  
Craig Johnstone ◽  
Mark D. Neuman ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Rapid Sequence Induction ◽  
Middle Income ◽  
Emergency Airway Management ◽  
Emergency Airway ◽  
Rapid Sequence ◽  
Sequence Induction

Background Tracheal intubation for patients with COVID-19 is required for invasive mechanical ventilation. The authors sought to describe practice for emergency intubation, estimate success rates and complications, and determine variation in practice and outcomes between high-income and low- and middle-income countries. The authors hypothesized that successful emergency airway management in patients with COVID-19 is associated with geographical and procedural factors. Methods The authors performed a prospective observational cohort study between March 23, 2020, and October 24, 2020, which included 4,476 episodes of emergency tracheal intubation performed by 1,722 clinicians from 607 institutions across 32 countries in patients with suspected or confirmed COVID-19 requiring mechanical ventilation. The authors investigated associations between intubation and operator characteristics, and the primary outcome of first-attempt success. Results Successful first-attempt tracheal intubation was achieved in 4,017/4,476 (89.7%) episodes, while 23 of 4,476 (0.5%) episodes required four or more attempts. Ten emergency surgical airways were reported—an approximate incidence of 1 in 450 (10 of 4,476). Failed intubation (defined as emergency surgical airway, four or more attempts, or a supraglottic airway as the final device) occurred in approximately 1 of 120 episodes (36 of 4,476). Successful first attempt was more likely during rapid sequence induction versus non–rapid sequence induction (adjusted odds ratio, 1.89 [95% CI, 1.49 to 2.39]; P < 0.001), when operators used powered air-purifying respirators versus nonpowered respirators (adjusted odds ratio, 1.60 [95% CI, 1.16 to 2.20]; P = 0.006), and when performed by operators with more COVID-19 intubations recorded (adjusted odds ratio, 1.03 for each additional previous intubation [95% CI, 1.01 to 1.06]; P = 0.015). Intubations performed in low- or middle-income countries were less likely to be successful at first attempt than in high-income countries (adjusted odds ratio, 0.57 [95% CI, 0.41 to 0.79]; P = 0.001). Conclusions The authors report rates of failed tracheal intubation and emergency surgical airway in patients with COVID-19 requiring emergency airway management, and identified factors associated with increased success. Risks of tracheal intubation failure and success should be considered when managing COVID-19. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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