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Protocol for a systematic review on effective patient positioning for rapid sequence intubation.
Asaanth Sivajohan1, Sarah Ct Krause2, Ahmed Hegazy3
1Schulich School of Medicine and Dentistry, London, Ontario, Canada asivajohan2024@meds.uwo.ca.
BMJ Open
|November 4, 2022
Summary
Patient positioning during rapid sequence intubation (RSI) impacts success. This systematic review compares different positions to optimize endotracheal intubation for high-aspiration risk patients.
Area of Science:
- Emergency Medicine
- Critical Care
- Airway Management
Background:
- Rapid sequence intubation (RSI) is crucial for securing airways in patients at high risk of aspiration.
- Optimal patient positioning during RSI remains debated, influencing intubation success and safety.
- Existing literature offers varied perspectives on patient positioning in RSI procedures.
Purpose of the Study:
- To systematically review and compare the effects of different patient positions on endotracheal intubation success during RSI.
- To synthesize current evidence regarding patient positioning strategies in rapid sequence intubation.
Main Methods:
- Comprehensive literature search of MEDLINE, EMBASE, and Cochrane Library (1946-2021).
- Inclusion of randomized controlled trials, cohort studies, case-control studies, and mannequin simulations.
- Data extraction by two independent reviewers, with bias assessment using established tools.
Main Results:
- Analysis of diverse patient positions and their impact on intubation success rates.
- Evaluation of effects on airway management difficulty and patient-relevant outcomes.
- Synthesis of evidence to identify optimal positioning strategies for RSI.
Conclusions:
- Patient positioning is a critical, yet inconsistently applied, factor in successful rapid sequence intubation.
- Evidence synthesis will guide clinical practice towards standardized, effective positioning techniques.
- Further research may be needed to definitively establish the best position for RSI across all patient demographics.
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