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Rapid sequence intubation in the emergency department
D G Dufour1, D L Larose, S C Clement
1Emergency Department, Hôpital du Haut-Richelieu, St-Jean-sur-le-Richelieu, Quebec, Canada.
The Journal of Emergency Medicine
|September 1, 1995
Summary
Rapid sequence intubation (RSI) is safe and effective for emergency physicians. This study found no mortality linked to neuromuscular blocking agents during RSI, supporting its use in emergency settings.
Area of Science:
- Emergency Medicine
- Anesthesiology
Background:
- Rapid sequence intubation (RSI) is increasingly used by emergency physicians.
- Concerns persist regarding the safety of neuromuscular blocking (NMB) agents in emergency settings.
- Limited data exist, primarily from tertiary care centers.
Purpose of the Study:
- To retrospectively review the experience with RSI in an emergency department.
- To assess the morbidity and mortality associated with RSI performed by emergency physicians.
- To evaluate the safety and effectiveness of NMB agents in the hands of emergency physicians.
Main Methods:
- Retrospective review of 219 intubations performed using an RSI protocol.
- Analysis of patient data for adverse events, including hypotension, cardiac arrhythmias, aspiration, and mortality.
- Assessment of intubation success rates.
Main Results:
- All 219 patients were successfully intubated using RSI.
- Adverse events included hypotension (24 patients), bigeminy (2 patients), and bradycardia (3 patients).
- Three cases of aspiration were documented; no mortality was attributed to NMB agents.
Conclusions:
- RSI is a safe and effective procedure when performed by emergency physicians.
- The use of NMB agents during RSI in emergency settings is associated with acceptable morbidity and no attributed mortality.
- These findings support the broader implementation of RSI by emergency medicine providers.