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Br J Nurs 2022 Jun;31(11):564-570

Consultant Intensivist, Intensive care unit; Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust.

Introduction: Airway management, including endotracheal intubation, is one of the cornerstones of care of critically ill patients. Internationally, health professionals from varying backgrounds deliver endotracheal intubation as part of their critical care role. This article considers the development of airway management skills within a single advanced critical care practitioner (ACCP) team and uses case series data to analyse the safety profile in performing this aspect of critical care. Read More

BMC Emerg Med 2022 Jun 3;22(1):94. Epub 2022 Jun 3.

Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand.

Background: There is limited evidence regarding factors associated with mortality in septic patients receiving etomidate. This study aimed to determine independent pre-intubation factors predicting 28-day mortality in septic patients receiving single-dose etomidate as an induction agent during rapid sequence intubation (RSI).

Methods: This single-center retrospective cohort study included intubated septic patients receiving etomidate as an induction agent during RSI in the emergency department of Siriraj hospital, Bangkok, Thailand, between January 1, 2016 and June 30, 2020. Read More

Prehosp Disaster Med 2022 Jun 3:1-7. Epub 2022 Jun 3.

Statistician, Aeromedical Retrieval, NSW Ambulance, NSW, Australia.

Study Objective: Structured review of video laryngoscopy recordings from physician team prehospital rapid sequence intubations (RSIs) may provide new insights into why prehospital intubations are difficult. The aim was to use laryngoscope video recordings to give information on timings, observed features of the airway, laryngoscopy technique, and laryngoscope performance. This was to both describe prehospital airways and to investigate which factors were associated with increased time taken to intubate. Read More

BMC Emerg Med 2022 May 28;22(1):91. Epub 2022 May 28.

Department of Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.

Background: There is paucity of literature on why and how patients are intubated, and by whom, in Irish Emergency Departments (EDs). The aim of this pilot study was to characterise emergency airway management (EAM) of critically unwell patients presenting to Irish EDs.

Methods: A multisite prospective pilot study was undertaken from February 10 to May 10, 2020. Read More

Anaesth Crit Care Pain Med 2022 May 27:101108. Epub 2022 May 27.

Department of Anaesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Electronic address:

The present study was designed to compare the intubating conditions of rocuronium giving by "a modified timing principle" in rapid induction and intubation (RSII) with that of the gold standard, succinylcholine. One hundred and twenty-four patients were randomly divided into rocuronium group (group R, n = 62) or succinylcholine group (group S, n = 62). In group R, after rocuronium 0. Read More

Anesth Analg 2022 Jun 10;134(6):e36-e37. Epub 2022 May 10.

Department of Anesthesiology CHU Brugmann, Université libre de Bruxelles, Bruxelles, Belgium.

Air Med J 2022 May-Jun;41(3):287-291. Epub 2022 Mar 17.

Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts. Electronic address:

Objective: Rocuronium is increasingly used as a first-line neuromuscular blocker (NMB) in rapid sequence intubation by transport teams. Prior work has shown that rocuronium is associated with a delay in postintubation sedation compared with intubation with succinylcholine.

Methods: Boston MedFlight is a consortium-based transport organization. Read More

Am J Respir Crit Care Med 2022 May 17. Epub 2022 May 17.

Vanderbilt University Medical Center, Division of Allergy, Pulmonary, and Critical Care, Nashville, Tennessee, United States;

Indian J Anaesth 2022 Mar 24;66(3):180-186. Epub 2022 Mar 24.

Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Background And Aims: Trauma is one of the leading causes of global disease burden. Data on airway management in trauma patients from developing countries, particularly India is sparse. Hence, we planned a prospective observational study to assess the airway management practice patterns and associated complications. Read More

Pediatr Emerg Care 2022 May 23;38(5):e1271-e1276. Epub 2021 Dec 23.

From the Departments of Emergency Medicine.

Background: Airway compromise and respiratory failure are leading causes of pediatric cardiac arrest making advanced airway management central to pediatric resuscitation. Previous literature has demonstrated that achieving first-pass success (FPS) is associated with fewer adverse events. In cardiac arrest for adult patients, increasing number of intubation attempts is associated with lower likelihood of return of spontaneous circulation (ROSC) and favorable neurologic outcome. Read More

Anaesthesist 2022 Apr 14. Epub 2022 Apr 14.

Klinik für Anästhesiologie, Operative Intensivmedizin, Schmerz- und Palliativmedizin, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Deutschland.

This is a case report of a 45-year-old patient, 39 weeks of gestation, who was intubated via rapid sequence induction (RSI) for an emergency cesarean. The indication for emergency cesarean was a pathological cardiotocography during the ejection phase following labor induction.Despite the primary use of a video laryngoscope, there was difficulty aligning the laryngeal axis. Read More

Ann Acad Med Singap 2022 03;51(3):149-160

Emergency Medicine Department, National University Hospital, Singapore.

Introduction: Evidence regarding the efficacy of high-flow nasal cannula (HFNC) oxygenation for preoxygenation and apnoeic oxygenation is conflicting. Our objective is to evaluate whether HFNC oxygenation for preoxygenation and apnoeic oxygenation maintains higher oxygen saturation (SpO) during rapid sequence intubation (RSI) in ED patients compared to usual care.

Methods: This was a multicentre, open-label, randomised controlled trial in adult ED patients requiring RSI. Read More

West J Emerg Med 2021 Jul 14;22(4):827-833. Epub 2021 Jul 14.

The University of Kansas Health System, Department of Emergency Medicine, Kansas City, Kansas.

Introduction: Intubation and mechanical ventilation are common interventions performed in the emergency department (ED). These interventions cause pain and discomfort to patients and necessitate analgesia and sedation. Recent trends in the ED and intensive care unit focus on an analgesia-first model to improve patient outcomes. Read More

J Clin Med 2022 Mar 18;11(6). Epub 2022 Mar 18.

Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.

Obese patients are predisposed to rapid oxygen desaturation during tracheal intubation. We aimed to compare the risk of desaturation between high-flow nasal oxygenation (HFNO) and classical facemask oxygenation (FMO) during rapid sequence intubation for elective surgery in obese patients. Adults with a body mass index ≥30 kg·m undergoing laparoscopic sleeve gastrectomy at a medical center were randomized into the HFNO group ( = 40) and FMO group ( = 40). Read More

Intensive Care Med 2022 05 17;48(5):634-635. Epub 2022 Mar 17.

Department of Anesthesiology and Pain Management, UT-Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA.

Front Med (Lausanne) 2022 25;9:813833. Epub 2022 Feb 25.

State Key Laboratory of Complex Severe and Rare Diseases, Department of Emergency, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Background: Tracheal intubation is a necessary but risky procedure performed in emergency departments (EDs) around the world. Relatively high morbidity has been encountered in Chinese EDs, which has raised concerns about peri-intubation ED management. This study aimed to investigate intubation procedures and identify any areas for improvement in Chinese EDs. Read More

J Spec Oper Med 2022 ;22(1):104-107

Management of hemorrhagic shock and airway stabilization are two pillars of trauma resuscitation which have a dependent, yet incompletely understood relationship. Patients presenting with traumatic hemorrhage may manifest shock physiology prior to intubation, conferring a higher risk of postintubation hypotension, pulseless arrest, and mortality. This case series describes of a group of seven US military members with combat-related trauma who experienced pulseless arrest after rapid sequence intubation in a role 2 or role 3 setting. Read More

Air Med J 2022 Jan-Feb;41(1):82-87. Epub 2021 Nov 15.

Carle Illinois College of Medicine, Champaign, IL.

Human factors engineering innovations, such as checklists, have been adopted in various acute care settings to improve safety with reasonable compliance and acceptance. In the air medical industry, checklists have been implemented by different teams for critical clinical procedures such as rapid sequence intubation. However, compliance and attitudes toward these human factors engineering innovations in the critical care transport setting are not well described. Read More

Intensive Care Med 2022 05 4;48(5):632-633. Epub 2022 Mar 4.

Department of Anesthesia and Critical Care, AP-HP, Hôpital Lariboisière, 75010, Paris, France.

Sci Rep 2022 02 28;12(1):3336. Epub 2022 Feb 28.

Division of General Anaesthesiology, Emergency- and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.

In unconscious individuals, rapid sequence intubation (RSI) may be necessary for cardiopulmonary stabilisation and avoidance of secondary damage. Opinions on such invasive procedures in people of older age vary. We thus sought to evaluate a possible association between the probability of receiving prehospital RSI in unconsciousness and increasing age. Read More

J Clin Anesth 2022 06 4;78:110675. Epub 2022 Feb 4.

AP-HP, Hôpital Lariboisière, Department of Anesthesia and Critical Care, F-75010 Paris, France; Université de Paris, Inserm, UMRS 942 Mascot, F-75006 Paris, France.

Anaesth Crit Care Pain Med 2022 04 1;41(2):101023. Epub 2022 Feb 1.

Department of Anaesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. Electronic address:

Cureus 2021 Dec 27;13(12):e20754. Epub 2021 Dec 27.

Emergency Medicine, Madigan Army Medical Center, Tacoma, USA.

Anterior cervical corpectomy, discectomy, and fusion are common surgical management options for symptomatic cervical radiculopathy and myelopathy. While these procedures are common and well-tolerated, postoperative complications span from mild dysphasia to airway compromise secondary to retropharyngeal or peri-cervical space abscess. These critical patients require robust airway management, which may entail a multidisciplinary approach or airway management in the operating room. Read More

Curr Opin Anaesthesiol 2022 Apr;35(2):182-188

Department of Anesthesiology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

Purpose Of Review: Rapid and effective airway management is priority for trauma patients. Trauma patients are often at an increased risk of experiencing hypoxia, and thus at increased risk of morbidity and mortality. Apneic oxygenation has been widely debated but has been reported to provide benefit in terms of increased peri-intubation oxygen saturation and decreased rates of desaturation. Read More

Pediatr Emerg Care 2022 Feb;38(2):e784-e790

Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center.

Objective: Develop a framework for data collection to determine the contributions of both laryngoscopy and tube delivery intervals to the apneic period in unsuccessful and successful attempts among patients undergoing rapid sequence intubation (RSI) in a pediatric emergency department (PED).

Design: This was a retrospective, observational study of RSI.

Setting: An academic PED. Read More

Minerva Anestesiol 2022 04 24;88(4):317-318. Epub 2022 Jan 24.

Department of Anesthesia, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Japan -

Acad Emerg Med 2022 Jun 15;29(6):719-728. Epub 2022 Mar 15.

South West Clinical School, University of New South Wales, Sydney, New South Wales, Australia.

Objective: The objective was to determine whether the use of fentanyl with ketamine for emergency department (ED) rapid sequence intubation (RSI) results in fewer patients with systolic blood pressure (SBP) measurements outside the pre-specified target range of 100-150 mm Hg following the induction of anesthesia. Methods This study was conducted in the ED of five Australian hospitals. A total of 290 participants were randomized to receive either fentanyl or 0. Read More

Intern Emerg Med 2022 Mar 17;17(2):611-617. Epub 2022 Jan 17.

Department of Emergency, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux cedex, France.

The Incidence of peri-intubation cardiac arrest (PICA) has been rarely assessed in the out-of-hospital setting. The objectives of this study were to assess the incidence and factors associated with PICA (cardiac arrest occurring within 15 min of intubation) in an out-of-hospital emergency setting, wherein emergency physicians perform standardized airway management using a rapid sequence intubation technique in adult patients. This was a secondary analysis of the "Succinylcholine versus Rocuronium for out-of-hospital emergency intubation" (CURASMUR) trial, which compared the first attempt intubation success rate between succinylcholine and rocuronium in adult patients requiring emergency tracheal intubation for any vital distress except cardiac arrest. Read More

J Emerg Med 2022 02 12;62(2):163-170. Epub 2022 Jan 12.

Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Flight For Life, Waukesha, Wisconsin.

Background: Rapid sequence intubation (RSI) is performed by helicopter emergency medical services (HEMS) providers to establish airway control. Common induction agents are etomidate and ketamine, both touted to have relatively stable hemodynamic profiles. Limited data comparing these medications in the air medical setting exist. Read More

Prehosp Emerg Care 2022 ;26(sup1):42-53

Airway management is a critical intervention for patients with airway compromise, respiratory failure, and cardiac arrest. Many EMS agencies use drug-assisted airway management (DAAM) - the administration of sedatives alone or in combination with neuromuscular blockers - to facilitate advanced airway placement in patients with airway compromise or impending respiratory failure who also have altered mental status, agitation, or intact protective airway reflexes. While DAAM provides several benefits including improving laryngoscopy and making insertion of endotracheal tubes and supraglottic airways easier, DAAM also carries important risks. Read More