Rapid Sequence Inductions in the ED

Author: Fiqry Fadhlillah / Editor: Beth Newstead / Reviewer: Tadgh Moriarty / Codes: / Published: 02/08/2021

This module is about the assessment and management of a deteriorating airway in the emergency department (ED).

Learning objectives:

  • Recognise a deteriorating airway
  • Be aware of the necessary steps for safe intubation
  • Appreciate the equipment necessary for the monitoring of patients undergoing intubation
  • Identify the roles of personnel involved in intubation
  • Demonstrate an understanding of the difficult airway algorithm
  • Demonstrate the steps to troubleshoot hypoxia post-intubation

References:

  1. Walls RM. Rapid Sequence intubation comes of age. Ann Emerg Med 1996;28:7981.
  2. Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet 1961;2:404-406.
  3. Butler JM, Clancy M, Robinson N, Driscoll P. An observational survey of emergency department rapid sequence intubation. Emerg Med J. 2001 Sep;18(5):343-8.
  4. April MD, Arana A, Pallin DJ, Schauer SG, et al. Emergency Department Intubation Success With Succinylcholine Versus Rocuronium: A National Emergency Airway Registry Study. Ann Emerg Med. 2018 Dec;72(6):645-653.
  5. Benger JR, Kirby K, Black S, Brett S, et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018;320(8):779-791.
  6. Wang HE, Schmicker RH, Daya MR, et al. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults with Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2018;320(8):769-778.
  7. Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31.
  8. Higgs A, McGrath BA, Goddard C, Rangasami J, et al. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth. 2018 Feb;120(2):323-352. doi: 10.1016/j.bja.2017.10.021. Epub 2017 Nov 26.
  9. Weingart S, Trueger N, Wong N, et al. Delayed Sequence Intubation: A Prospective Observational Study. Annals of Emergency Medicine 2015 65(4): 349-355.
  10. Crooke J, The Bearded airway. Anaesthesia May 1999; 54(5): 500. Alexander R, Overcoming the beard.
  11. Moore EW, Cowan CM. A close shave. Anaesthesia. 1999 Mar;54(3):305. doi: 10.1046/j.1365-2044.1999.0811r.x. PMID: 10364884.

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