Tag Archives: RSI

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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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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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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Guideline improved pre-hospital RSI in kids

French physicians provide pre-hospital critical care in medical teams of regional SAMU (service d’aide me ́dicale urgente). A national guideline was introduced in France to guide the management of traumatic brain injury (TBI), which included airway management. A study was conducted … Continue reading

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Pre-hospital intubation experience and outcomes

Hospitals and medical personnel performing high volumes of procedures demonstrate better patient outcomes and fewer adverse events. The relationship between rescuer experience and patient survival for out-of-hospital endotracheal intubation is unknown. An American study analysing 3 statewide databases with 26,000 … Continue reading

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The myth of ketamine and head injury

A literature review addresses the myth that ketamine is contraindicated in head injured patients. They summarise articles from the 1970’s which identified an association between ketamine and increased ICP in patients with abnormal cerebrospinal fluid pathways (such as those caused … Continue reading

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Current Controversy in RSI

A review article in Anesthesia and Analgesia provides a summary of the literature surrounding RSI controversies. Should a pre-determined dose of induction drug be given or should it be titrated to effect prior to giving suxamethonium? Should fast acting opioids … Continue reading

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