Tag Archives: airway

Pre-hospital RSI by different specialties

This aim of the study was to evaluate the tracheal intubation success rate of doctors drawn from different clinical specialities performing rapid sequence intubation (RSI) in the pre-hospital environment operating on the Warwickshire and Northamptonshire Air Ambulance. Over a 5-year … Continue reading

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EM trainee RSI experience

A single centre observational study of rapid sequence intubation (RSI) was performed in a Scottish Emergency Department (ED) over four and a quarter years, followed by a postal survey of ED RSI operators. There were 329 RSIs during the study … Continue reading

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Paediatric Tube Cuff Pressures

A paediatric critical care transport service encountered elevated tracheal tube cuff pressures (>30 cmH20) in 41% of 60 consecutive care studied, and over 60 cmH20 in 30%. This measurement was taken on arrival at the bedside, not in flight. Cuffed … Continue reading

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Alternative toothless mask position

An alternative position for holding the facemask when bag-mask ventilating edentulous patients is described and evaluated. 49 patients with inadequate seal and air leak during two-hand positive-pressure ventilation had significantly improved ventilation as measured by reduced air leak and increased … Continue reading

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Unexpected survivors after pre-hospital intubation

Data on patients with moderate to severe traumatic brain injury from the San Diego Trauma Registry were analysed using modified TRISS methodology to determine predicted survival, from which an observed-predicted survival differential (OPSD) was calculated. The mean OPSD was calculated … Continue reading

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Etomidate in RSI – systematic review

A systematic review of 20 included studies comparing a bolus dose of etomidate for rapid sequence induction with other induction agents resulted in the following conclusion: “The available evidence suggests that etomidate suppresses adrenal function transiently without demonstrating a significant … Continue reading

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Tracheal tube cuff pressure in flight

Tracheal tube cuff pressures increased from a mean 28.7 cm H2O pre-flight to 62.6 cm H2O in flight (mean altitude increase 2260 feet) in a Swiss helicopter-based study. At cruising altitude, 98% of patients had intracuff pressure >30 cm H2O, 72% had … Continue reading

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Less RSI desaturation with Roc

Some of my pre-hospital critical care colleagues in the UK exclusively use rocuronium in preference to suxamethonium for rapid sequence induction (RSI) of anaesthesia in critically ill patients. I couldn’t see a good reason to switch although now there’s some … Continue reading

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Pre-hospital RSI successes

A couple of papers in Prehospital Emergency Care this month contribute to the pre-hospital airway management / rapid sequence intubation (RSI) literature. Intensive physician oversight of a pre-hospital RSI program increased the prescription of post-intubation morphine and midazolam, and decreased … Continue reading

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Pre-hospital RSI

Physicians from HEMS London document their experience of 400 pre-hospital rapid sequence induction / intubations. Their data are consistent with the experience of other similar services and with the emergency airway management literature in general: Failure to intubate is rare … Continue reading

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