Rapid Sequence Intubation Improves Extubation Rates for Emergently Intubated Critically Ill Patients

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 198A ◽  
Author(s):  
Kavan Ramachandran ◽  
Kishan Ramachandran ◽  
Prashant Gundre ◽  
Yizhak Kupfer ◽  
Chanaka Seneviratne ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

913: Increased Mortality With Succinylcholine for Rapid Sequence Intubation in Critically Ill Patients

2020 ◽  
Vol 49 (1) ◽  
pp. 453-453
Author(s):  
Emily Bodin ◽  
Molly Howell ◽  
Todd Walroth ◽  
David Foster ◽  
Serena Dine ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

scholarly journals Airway Management in the Pre-Hospital Setting

2020 ◽  
Author(s):  
Lamia Tawfik ◽  
Mohammad Al Nobani ◽  
Tarek Tageldin
Keyword(s):  
Airway Management ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hospital Setting ◽  
Morbidity And Mortality ◽  
Rapid Sequence Intubation ◽  
Medical Providers ◽  
Rapid Sequence ◽  
Research Findings

This chapter explores the different techniques and challenges faced by emergency medical providers during pre-hospital airway management of critically ill patients. It is a crucial topic that has a major impact on patient’s safety. Improper airway management in this category of patients can lead to catastrophic results in terms of morbidity and mortality, this fact stimulates the ongoing improvement and evolution in this area of practice. We explore some of the debatable topics in pre-hospital airway management like airway management in the pediatric group, the use of medication assisted intubation and rapid sequence intubation in the field as well as the role of video assisted intubation and it’s challenges in the field. The up-to-date practices and research findings in the most recent related articles are discussed here in this chapter.

scholarly journals (A179) A Survey of Rapid Sequence Intubation (RSI) Complications in Immam Hossein Medical Center Carried Out by Emergency Residents

2011 ◽  
Vol 26 (S1) ◽  
pp. s51-s52
Author(s):  
H. Hatamabadi ◽  
I. Golkhatir ◽  
A. Amini ◽  
M. Alavi Moghadam
Keyword(s):  
Emergency Medicine ◽  
Success Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Center ◽  
Rapid Sequence Intubation ◽  
Emergency Airway ◽  
Emergency Medicine Resident ◽  
Rapid Sequence ◽  
Significant Difference

IntroductionCritically ill patients in emergency department frequently require emergency airway management. This procedure in our ED is carried out by emergency medicine resident with rapid sequence intubation (RSI). This study investigates complications of tracheal intubation carried out in critically ill patients including: (1) hypoxemia and hypotension (2) aspiration and esophageal displacement (3) pneumothorax and right bronchus intubation.MethodsData were collected on consecutive intubations carried out by EM residents over a 29 months period. Between 195 patients only 100 patients had including criteria to enter this study. Also we compare the complications and success rate among three level of personnel carrying on the procedure.(first to third year of emergency medicine residency).Results109 consecutive intubations were carried on in 100 patients. Oral translaryngeal intubation was done in all patients. Three intubations required more than 2 attempts and hypoxia occurred in 34 cases. Aspiration was diagnosed by direct vision in 5 cases. Hypotension was found in 5 cases causing death in 3 of them during the intubation or in 30 minutes following the procedure. Esophageal displacement occurred in 10 of the attempts but all were recognized and reintubated. Success rate between three personnel levels are as follow: in first year residency 82% and in second year residency 94% and in third year residency is 100% (p = 0.014).There was not a statistically significant difference among these three groups considering the complications but the success rate should a difference between level 1 and 3 (p = 0.936). Multiple attempts did not increase the rate of complications. Mortality were dependent to hypotension (p = 0.019) and age (p = 0.001).ConclusionIn our study we did not find the results of RSI to be operator dependent as long as it was done by emergency residents. It is recommended to compare the results of RSI and non- RSI methods in a future.

scholarly journals Pro-Con Debate: Etomidate or Ketamine for Rapid Sequence Intubation in Pediatric Patients

2012 ◽  
Vol 17 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Daniel Scherzer ◽  
Mark Leder ◽  
Joseph D. Tobias
Keyword(s):  
Airway Management ◽  
Critically Ill ◽  
Safety Concern ◽  
Essential Element ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Critically Ill Children ◽  
Rapid Sequence Intubation ◽  
Airway Control ◽  
Rapid Sequence

When caring for critically ill children, airway management remains a primary determinant of the eventual outcome. Airway control with endotracheal intubation is frequently necessary. Rapid sequence intubation (RSI) is generally used in emergency airway management to protect the airway from passive regurgitation of gastric contents. Along with a rapid acting neuromuscular blocking agent, sedation is an essential element of RSI. A significant safety concern regarding sedatives is the risk of hypotension and cardiovascular collapse, especially in critically ill patients or those with pre-existing comorbid conditions. Ketamine and etomidate, both of which provide effective sedation with limited effects on hemodynamic function, have become increasingly popular as induction agents for RSI. However, experience and clinical investigations have raised safety concerns associated with both etomidate and ketamine. Using a pro-con debate style, the following manuscript discusses the use of ketamine versus etomidate in RSI.

KETAMINE VS ETOMIDATE FOR RAPID SEQUENCE INTUBATION IN THE CRITICALLY ILL POPULATION

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A204
Author(s):  
Vincent Kang ◽  
Gabrielle Sabino ◽  
Steven Wu ◽  
Jordan Arends ◽  
John Elliott ◽  
...  
Keyword(s):  
Critically Ill ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

scholarly journals Apneic Oxygenation during Rapid Sequence Intubation in Critically Ill Children

2015 ◽  
Vol 05 (01) ◽  
pp. 028-031 ◽  
Author(s):  
Todd Mortimer ◽  
Jeff Burzynski ◽  
Murray Kesselman ◽  
Jeff Vallance ◽  
Gregory Hansen
Keyword(s):  
Critically Ill ◽  
Critically Ill Children ◽  
Rapid Sequence Intubation ◽  
Apneic Oxygenation ◽  
Rapid Sequence

Anesthesiologist and Emergency Medicine Physician Attitudes and Knowledge Regarding Etomidate for Intubation

2018 ◽  
Vol 35 (10) ◽  
pp. 1008-1012 ◽  
Author(s):  
David Clinkard ◽  
Fran Priestap ◽  
Stacy Ridi ◽  
Eric Bruder ◽  
Ian M. Ball
Keyword(s):  
Emergency Medicine ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Physician Attitudes ◽  
Adrenal Suppression ◽  
Rapid Sequence Intubation ◽  
Induction Agent ◽  
Emergency Medicine Physician ◽  
Medicine Physician ◽  
Significant Difference

Purpose: The use of etomidate as an induction agent for critically ill patients is controversial. While its favorable hemodynamic profile is enviable, etomidate has been shown to cause transient adrenal suppression. The clinical consequences of transient adrenal suppression are poorly understood. Anecdotally, some clinicians advocate strongly for etomidate, while others feel it can cause significant harm. To better understand the current clinical environment with respect to single-dose etomidate use in critically ill patients, Canadian anesthesiologists and Canadian emergency medicine (EM) physicians were questioned regarding their opinions, knowledge, and preferences about etomidate use as an induction agent. Methods: Invitations to participate with the electronic survey were sent to 100 Canadian EM physicians and 260 Canadian anesthesiologists. The survey had 4 general parts: demographics, familiarity with the current literature, choice of induction agent given various clinical scenarios, and opinions on the controversy. The Pearson γ2 test was used to detect whether significant differences exist between physician groups. Results: Ninety three anesthesiologists and 42 EM physicians responded for response rates of 36% and 42%. There were no self-reported differences in knowledge about etomidate properties between EM physicians and anesthesiologists. There were significant differences in etomidate use between EM physicians and anesthesiologists in general rapid sequence intubation, noncritically ill patients, and those with undifferentiated hypotension. Both EM physicians and anesthesiologists describe the current etomidate controversy as significant and not adequately resolved. Conclusion: There is no significant difference in self-reported etomidate knowledge between anesthesiologists and EM physicians; however, significant practice pattern differences exist with EM physicians using etomidate more often. Broad agreement supports future research to investigate etomidate’s impact in critically ill patients.

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