Rapid sequence intubation in the emergency department

J Emerg Med. Sep-Oct 1995;13(5):705-10. doi: 10.1016/0736-4679(95)00089-s.

Abstract

Rapid sequence intubation (RSI) has recently gained wide acceptance among emergency physicians (EP). The debate regarding the safety of neuromuscular blocking (NMB) agents in the hands of EPs nonetheless remains open, as objective studies are few, and all data available so far come from tertiary care centers. This retrospective study was done to review our experience with RSI and assess the related morbidity and mortality. Two hundred and nineteen intubations were done using an RSI protocol during the study period. Hypotension occurred in 24 patients. Two patients had a short run of bigeminy and 3 had bradycardia. One patient went into cardiac arrest unrelated to the use of a NMB agent. Aspiration was documented in 3 patients. All patients were successfully intubated. No mortality was attributed to the use of muscle relaxants. Our results support the safety and effectiveness of RSI in the hands of emergency physicians.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Central Nervous System Agents / adverse effects
  • Central Nervous System Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Emergency Medical Services*
  • Female
  • Humans
  • Infant
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / methods*
  • Intubation, Intratracheal / mortality
  • Male
  • Medical Audit
  • Middle Aged
  • Neuromuscular Depolarizing Agents / adverse effects
  • Neuromuscular Depolarizing Agents / therapeutic use*
  • Premedication / adverse effects
  • Premedication / methods*
  • Quebec
  • Retrospective Studies
  • Safety

Substances

  • Central Nervous System Agents
  • Neuromuscular Depolarizing Agents