An observational survey of emergency department rapid sequence intubation

Citation
Jm. Butler et al., An observational survey of emergency department rapid sequence intubation, EMERG MED J, 18(5), 2001, pp. 343-348
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
EMERGENCY MEDICINE JOURNAL
ISSN journal
1472-0205 → ACNP
Volume
18
Issue
5
Year of publication
2001
Pages
343 - 348
Database
ISI
SICI code
1472-0205(200109)18:5<343:AOSOED>2.0.ZU;2-R
Abstract
Objectives-To study the current practice of rapid sequence intubations (RSI s) in four different emergency medicine training programmes in the UK. Methods-Observational study design involving four regional training program mes (Wessex, North West, Yorkshire, Avon). Data were collected in real time using a previously piloted survey tool. Data were collected by specialist registrars in emergency medicine over a continuous 28 day period. Data coll ected included: indications for RSI; key timings of RSI procedures; details of RSI practitioner; complications and outcome of procedure. Results-Data from 60 RSIs were recorded and collected. The majority of deci sions to perform RSIs were made by emergency physicians (74% cases). Over 5 0% of the RSIs occurred after 4 pm. Emergency physicians performed 26% of R SIs although the majority were performed by anaesthetists. Most of the give n indications for RSIs were based on an assessment of airway protection. Hy poxia was an uncommon reason for RSI in this study (5%). In two thirds of c ases the time taken from the decision being made to perform an RSI, to the achievement of successful intubation, was greater than 20 minutes. No faile d intubations were recorded, although six other complications (all minor pr oblems) were recorded. There was no significant difference in the response times between anaesthetists and emergency physicians. Conclusions-This study shows that emergency physicians are currently perfor ming RSIs in emergency departments in the UK. It also suggests improvements could be made to patient care. In particular, standards of care should be agreed for the provision of RSI in the emergency department, including the personnel involved and the appropriate training of individuals. RSI activit y in emergency departments in the UK should be audited nationally using an agreed audit tool.