The cornerstone of emergency airway management is rapid sequence induction of anaesthesia with tracheal intubation (rapid sequence intubation, or RSI). The significantly lower complication rates in emergency department RSI can be explained by a larger proportion of patients with comparatively stable cardiorespiratory function.Įmergency medical care begins with the airway. Complication rates are comparable between anaesthetists and non-anaesthetists. The likelihood of immediate complications depends on the patient’s underlying condition, and relevant diagnoses should be emphasised in airway management training. There were no significant differences in complication rates between these groups.Ĭonclusions: RSI has a significant immediate complication rate, although the clinical significance of transient events is unknown. Intubating teams comprised anaesthetists, non-anaesthetists, or both. This can be explained by the difference in diagnostic case mix. Emergency department intubations were associated with a significantly lower complication rate than other locations (16.9% p = 0.004). Hypoxaemia was more common in patients with pre-existing respiratory or cardiovascular conditions than in patients with other diagnoses (p<0.01). Immediate complications were hypoxaemia 19.2%, hypotension 17.8%, and arrhythmia 3.4%. Patient diagnostic groups requiring RSI are described. There were no deaths during the procedure and no patient required a surgical airway. Results: Patients were successfully intubated by RSI in all cases. Methods: Prospective observational study of 208 consecutive adult and paediatric patients undergoing RSI over a six month period. Complication rates are unknown for this procedure in the United Kingdom and the factors contributing to immediate complications have not been identified.Īims: To quantify the immediate complications of RSI and to assess the contribution made by environmental, patient, and physician factors to overall complication rates. Background: Emergency rapid sequence intubation (RSI) performed outside the operating room on emergency patients is the cornerstone of emergency airway management.
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