Airway management in patients with a broadcomplex tachycardia requiring electrical cardioversion: a postal survey

This study was to determine whether or not ED and ICU consultants would intubate an unstarved, haemodynamically unstable patient with a BCT requiring electrical cardioversion, and to determine the incidence of complications for both intubating and not intubating based on the responders personal experience. 174 postal questionnaires were sent to ED and ICU consultants in the Wessex and South West regions of England. They were asked whether or not they would intubate a patient that required electrical cardioversion for a BCT with hypotension. 139 responded: 77 (56%) elected to intubate the patient always or most of the time, 34 (24%) would rarely or never intubate the patient, and 28 (20%) would only do so sometimes. Responders were aware of significant complications from both intubating and not intubating such a patient. Intubation for an unstarved patient with a haemodynamically compromising BCT would seem to occur on a variable basis. ED consultants were more likely to sedate such a patient without intubation whereas ICU consultants were more likely to intubate them.