Search Our Scientific Publications & Authors

Acad Emerg Med 2019 Mar 4. Epub 2019 Mar 4.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.

Background: The optimal order of drug administration (sedative first vs. neuromuscular blocking agent first) in rapid sequence intubation (RSI) is debated.

Objective: We sought to determine if RSI drug order was associated with the time elapsed from administration of the first RSI drug to the end of a successful first intubation attempt. Read More

Scand J Trauma Resusc Emerg Med 2019 Feb 26;27(1):23. Epub 2019 Feb 26.

Department of Medicine - ADAC Air Rescue Service, Hansastrasse 19, 80686, Munich, Germany.

Background: Airway management and use of intravenous anaesthetics to facilitate tracheal intubation after major trauma remains controversial. Numerous agents are available and used for pre-hospital rapid-sequence induction (RSI). The aim was to investigate usage and potential changes in administration of intravenous anaesthetics for pre-hospital RSI in trauma patients over a ten-year period. Read More

Scand J Trauma Resusc Emerg Med 2019 Feb 13;27(1):17. Epub 2019 Feb 13.

Air Zermatt, Emergency Medical Service, 3920, Zermatt, Switzerland.

Background: Human external cargo (HEC) extrication during helicopter rescue missions is commonly used in mountain emergency medical services. Furthermore, longline or winch operations offer the opportunity to deliver professional medical care onsite. As the safety and quality of emergency medical care depends on training and experience, we aimed to investigate characteristics of mountain rescue missions with HEC. Read More

Anesth Essays Res 2018 Oct-Dec;12(4):865-872

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

Context: Although international guidelines have been developed for emergency tracheal intubation (ETI), there is little evidence of their applicability in developing countries.

Aims: The aim of this study was done to evaluate the different methods of ETI that are practiced among anesthetist and anesthesia trainees in India outside operating room (OR)/intensive care unit (ICU) settings.

Settings And Design: This was prospective observational audit did among anesthesia personals managing ETI outside OR and ICU. Read More

Acta Anaesthesiol Scand 2019 May 15;63(5):587-593. Epub 2019 Jan 15.

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

Background: Ketamine is an induction agent frequently used for general anaesthesia in emergency medicine. Generally regarded as haemodynamically stable, it can cause hypertension and tachycardia and may cause or worsen shock. The effects of ketamine may be improved by the addition of fentanyl to the induction regime. Read More

Am J Case Rep 2019 Jan 10;20:39-42. Epub 2019 Jan 10.

Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

BACKGROUND Ehlers-Danlos syndrome, hypermobility type is characterized by increased extensibility, permeability, and fragility of the affected cartilaginous tissues, including the trachea, larynx, and skin. Anesthetic considerations for patients with this syndrome include intubation difficulties secondary to the collapse of fibro-elastic tissues in the trachea and a reported resistance to local anesthetics. CASE REPORT Our patient was a 22-year-old G4P0030 woman with a history of morbid obesity, seizures, Barrett's esophagus, hypermobility being evaluated for Ehlers-Danlos syndrome, and anaphylaxis to an unknown local anesthetic who was scheduled for cesarean delivery. Read More

F1000Res 2018 23;7. Epub 2018 Oct 23.

Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.

Effective mask ventilation is an essential skill for any practitioner engaged in airway management. Recent methods to objectively describe mask ventilation using waveform capnography help practitioners to monitor and communicate the effectiveness of mask ventilation. Gentle mask ventilation is now considered acceptable during rapid sequence induction/intubation after loss of consciousness, hence reducing the incidence of hypoxia prior to tracheal intubation. Read More

Prehosp Disaster Med 2018 Dec 9;33(6):668-672. Epub 2018 Nov 9.

Department of Emergency Medicine,Navy Medical Center Portsmouth,Portsmouth,VirginiaUSA.

IntroductionEmergency physicians are using bolus-dose vasopressors to temporize hypotensive patients until more definitive blood pressure support can be established. Despite a paucity of clinical outcome data, emergency department applications are expanding into the prehospital setting. This series presents two cases of field expedient vasopressor use by emergency medicine providers for preflight stabilization during aeromedical evacuation to a hospital ship as part of the United States Navy disaster response in Puerto Rico. Read More

Int J Obstet Anesth 2018 Nov 1;36:3-10. Epub 2018 Jun 1.

Department of Anaesthetics, University Hospital Coventry, Clifford Bridge Road, CV2 2DX Coventry, United Kingdom.

Background: In view of newer techniques of preoxygenation and laryngoscopy and recent obstetric guidelines concerning the management of difficult intubation, we aimed to evaluate the current practice of rapid sequence induction for caesarean section in England.

Methods: In 2017, 316 questionnaire surveys were posted to all 158 hospitals with caesarean section capabilities in England. At each hospital, one questionnaire was to be completed by the obstetric anaesthetic consultant lead and one by an anaesthetic trainee. Read More

J Clin Anesth 2019 May 31;54:11-12. Epub 2018 Oct 31.

Department of Anesthesiology, Osaka Medical College, Japan.

JAMA Surg 2019 Jan;154(1):9-17

Sorbonne Université, UMR Inserm, Institut hospitalo-universitaire ICAN, Department of Emergency Medicine and Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.

Importance: The use of cricoid pressure (Sellick maneuver) during rapid sequence induction (RSI) of anesthesia remains controversial in the absence of a large randomized trial.

Objective: To test the hypothesis that the incidence of pulmonary aspiration is not increased when cricoid pressure is not performed.

Design, Setting, And Participants: Randomized, double-blind, noninferiority trial conducted in 10 academic centers. Read More

Am Surg 2018 Sep;84(9):1504-1508

Present guidelines for emergency intubation in traumatically injured patients recommend rapid sequence intubation (RSI) as the preferred method of airway management but specific pharmacologic agents for RSI remain controversial. To evaluate hemodynamic differences between propofol and other induction agents when used for RSI in trauma patients. Single-center, retrospective review of trauma patients intubated in the emergency department. Read More

Turk J Anaesthesiol Reanim 2018 Sep 17;46(5):367-372. Epub 2018 Aug 17.

Department of Anaesthesiologu and Reanimation, Ankara University School of Medicine, Ankara, Turkey.

Objective: We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients.

Methods: One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified according to the American Association of Anesthesiologists as Class II and III were randomized into four groups. After pre-oxygenation for 3 minutes, induction and tracheal intubation were performed by blinded investigators, who also scored the intubation. Read More

J Intensive Care Soc 2018 Aug 17;19(3):180-187. Epub 2018 Jan 17.

General Intensive Care Unit, St George's University Hospitals NHS Foundation Trust, London, UK.

Introduction: We evaluated intensive care medicine trainees' practice of emergency intubations in the United Kingdom.

Methods: Retrospective analysis of 881 in-hospital emergency intubations over a three-year period using an online trainee logbook.

Results: Emergency intubations out-of-hours were less frequent than in-hours, both on weekdays and weekends. Read More

J Intensive Care 2018 13;6:49. Epub 2018 Aug 13.

2Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014 India.

Background: Endotracheal intubation in critically ill is a high-risk procedure requiring significant expertise in airway handling as well as understanding of pathophysiology of the disease process.

Main Body: Critically ill patients are prone for hypotension and hypoxemia in the immediate post-intubation phase due to blunting of compensatory sympathetic response. Preoxygenation without NIV is frequently suboptimal, as alveolar flooding cause loss of alveolar capillary interface in many of these patients. Read More

Adv Emerg Nurs J 2018 Jul/Sep;40(3):183-193

Vanderbilt LifeFlight, Vanderbilt School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee.

Within emergency care settings, rapid sequence intubation (RSI) is frequently used to secure a definitive airway (i.e., endotracheal tube) to provide optimal oxygenation and ventilation in critically ill patients of all ages. Read More

Anaesthesia 2018 Oct 25;73(10):1229-1234. Epub 2018 Jul 25.

Guy's and St. Thomas' NHS Foundation Trust, London, UK.

Cricoid pressure is employed during rapid sequence induction to reduce the risk of pulmonary aspiration. Correct application of cricoid pressure depends on knowledge of neck anatomy and precise identification of surface landmarks. Inaccurate localisation of the cricoid cartilage during rapid sequence induction risks incomplete oesophageal occlusion, with potential for pulmonary aspiration of gastric contents. Read More

Am J Emerg Med 2019 Apr 12;37(4):706-709. Epub 2018 Jul 12.

Department of Emergency Medicine, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL, United States of America.

Introduction: Rapid and accurate confirmation of endotracheal tube (ETT) placement is a fundamental step in definitive airway management. Multiple techniques with different limitations have been reported. Recent studies have evaluated the accuracy, time to performance, and physician confidence for ultrasound in both cadaveric models and live patients. Read More

Resuscitation 2018 09 3;130:57-60. Epub 2018 Jul 3.

University of Texas Health Science Center, McGown School of Medicine, 6431 Fannin Street, 4th Floor JJL, Houston, TX 77030, United States.

Background: We sought to characterize the number of attempts required to achieve advanced airway management (AAM) success.

Methods: Using 4 years of data from a national EMS electronic health record system, we examined the following subsets of attempted AAM: 1) cardiac arrest intubation (CA-ETI), 2) non-arrest medical intubation (MED-ETI), 3) non-arrest trauma intubation (TRA-ETI), 4) rapid-sequence intubation (RSI), 5) sedation-assisted ETI (SAI), and 6) supraglottic airway (SGA). We determined the first pass and overall success rates, as well as the point of additional attempt futility ("plateau point"). Read More

J Emerg Trauma Shock 2018 Apr-Jun;11(2):92-97

Department of Emergency Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.

Introduction: Airway and breathing management play critical role in trauma resuscitation. Early identification of esophageal intubation and detection of fatal events is critical. Authors studied the utility of integration of point-of-care ultrasound (POCUS) during different phases of rapid sequence intubation (RSI) in trauma resuscitation. Read More

Emerg Med J 2018 Sep 24;35(9):532-537. Epub 2018 May 24.

Centre for Trauma Sciences, Queen Mary University of London, London, UK.

Introduction: Prehospital emergency anaesthesia (PHEA or 'prehospital rapid sequence intubation') is a high-risk procedure. Standard operating procedures (SOPs) and checklists within healthcare systems have been demonstrated to reduce human error and improve patient safety. We aimed to describe the current practice of PHEA in the UK, determine the use of checklists for PHEA and describe the content, format and layout of any such checklists currently used in the UK. Read More

A A Pract 2018 May;10(9):242-245

Department of Otolaryngology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Read More

Br J Anaesth 2018 May;120(5):1103-1109

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway; Department of Health Sciences, University of Stavanger, Stavanger, Norway.

Background: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams.

Methods: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management. Read More

ANZ J Surg 2018 May 23;88(5):455-459. Epub 2018 Mar 23.

John Hunter Hospital, The University of Newcastle, Newcastle, New South Wales, Australia.

Background: The role of prehospital endotracheal intubation (PETI) for traumatic brain injury is unclear. In Victoria, paramedics use rapid sequence induction (RSI) drugs to facilitate PETI, while in New South Wales (NSW) they do not have access to paralysing agents. We hypothesized that RSI would both increase PETI rates and improve mortality. Read More

West J Emerg Med 2018 Mar 22;19(2):403-411. Epub 2018 Feb 22.

University of California Irvine Health, Department of Emergency Medicine, Orange, California.

Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e. Read More

Expert Rev Med Devices 2018 Apr 12;15(4):265-275. Epub 2018 Mar 12.

a Department of Anesthesiology , Chang Gung Memorial Hospital , Taoyuan , Taiwan.

Introduction: Video laryngoscopy-assisted tracheal intubation devices have become alternatives to traditional laryngoscopes in recent years. This review will provide information on commonly used video laryngoscopes and their clinical applications in airway management. Areas covered: In this review, the differences between video laryngoscopy and direct laryngoscopy, and the utilization of video laryngoscopes in specific clinical settings are discussed. Read More

Injury 2018 May 12;49(5):916-920. Epub 2018 Feb 12.

Ambulance Victoria, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia.

Introduction: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation. Read More

Br J Anaesth 2018 Feb 26;120(2):323-352. Epub 2017 Nov 26.

Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK(12).

These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4 National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not. Read More

Ann Emerg Med 2018 05 17;71(5):597-607.e3. Epub 2018 Jan 17.

Williamson County Emergency Medical Services, Georgetown, TX, and Texas A&M Health Science Center, Temple, TX.

Study Objective: Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies.

Methods: We used EMS data from ESO Solutions, a national EMS electronic health record system. Read More

J Emerg Med 2018 04 10;54(4):395-401. Epub 2018 Jan 10.

Department of Emergency Medicine, Arrowhead Regional Medical Center, Colton, California; Air Methods Corporation, Englewood, Colorado; California University of Science and Medicine, San Bernardino, California.

Background: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients.

Objective: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort. Read More

Anaesthesia 2018 Mar 8;73(3):348-355. Epub 2018 Jan 8.

Emergency Medicine and Services, Helsinki University Hospital and Department of Emergency Medicine, University of Helsinki, Finland.

Results using videolaryngoscopy in pre-hospital rapid sequence intubation are mixed. A bougie is not commonly used with videolaryngoscopy. We hypothesised that using videolaryngoscopy and a bougie as core elements of a standardised protocol that includes a drugs and a laryngoscopy algorithm would result in a high first-pass tracheal intubation success rate. Read More

Prehosp Emerg Care 2018 May-Jun;22(3):300-311. Epub 2018 Jan 3.

Objective: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI.

Methods: Electronic patient monitor data files from cases in which paramedic RSI was attempted were prospectively collected over a 15-month study period to supplement the standard EMS patient care documentation. Read More

Anaesthesia 2018 Mar 19;73(3):304-312. Epub 2017 Dec 19.

Department of Anaesthesia and Intensive Care, Hôpital Femme Mère Enfant, Bron, France.

Ultrasound examination of the gastric antrum is a non-invasive tool that allows reliable estimation of gastric contents. We performed this prospective cohort study in non-elective paediatric surgery to assess whether gastric ultrasound may help to determine the best anaesthetic induction technique, whether rapid sequence or routine. The primary outcome was the reduction of inappropriate induction technique. Read More

J Crit Care 2018 04 10;44:191-195. Epub 2017 Nov 10.

The Department of Medicine, Division of Pulmonary Critical Care & Sleep, United States. Electronic address:

Background: The Montpellier protocol for intubating patients in the intensive care unit (ICU) is associated with a decrease in intubation-related complications. We sought to determine if implementation of a simplified version of the Montpellier protocol that removed selected components and allowed for a variety of pre-oxygenation modalities increased first-pass intubation success and reduced intubation-related complications.

Methods: A prospective pre/post-comparison of a modified Montpellier protocol in two medical and one medical/surgical/cardiac ICU within a hospital system. Read More

Paediatr Anaesth 2017 12;27(12):1278

Department of Anesthesiology, Seth GS Medical College and KEM Hospital, Mumbai, India.

Adv Emerg Nurs J 2017 Oct/Dec;39(4):309-317

Emergency Department, Naval Medical Center Portsmouth, Portsmouth, Virginia.

Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. Over the last 5 years, there have been several studies published on this topic with differing results. Read More

Adv Emerg Nurs J 2017 Oct/Dec;39(4):266-279

Vanderbilt University School of Nursing and Vanderbilt University Medical Center-LifeFlight, Nashville, Tennessee (Dr Gooch); TeamHealth at Maury Regional Medical Center, Columbia, Tennessee (Dr Gooch); Middle Tennessee School of Anesthesia, Madison, Tennessee (Dr Gooch); and Loyola University Chicago Marcella Niehoff School of Nursing, Chicago, Illinois (Dr Roberts).

Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Read More

BMJ Case Rep 2017 Oct 19;2017. Epub 2017 Oct 19.

Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

We present a case that highlights the issues surrounding the delivery of a safe general anaesthetic to a patient with Huntington's disease (HD) and bulbar dysfunction. In the case of a 46-year-old patient undergoing laparoscopic percutaneous endoscopic gastrostomy tube insertion, we discuss the rationale behind our chosen method and anaesthetic agents as well as airway issues specific to HD. In a patient whose condition would not allow for an awake fibreoptic intubation, we opted for a modified rapid sequence induction. Read More

Emerg Med J 2018 Jan 10;35(1):62-64. Epub 2017 Oct 10.

Department of Emergency Medicine, Lincoln Medical Center, New York City, New York, USA.

Purpose: We sought to evaluate the utility of waveform capnography (WC) in detecting paralysis, by using apnoea as a surrogate determinant, as compared with clinical gestalt during rapid sequence intubation. Additionally, we sought to determine if this improves the time to intubation and first pass success rates through more consistent and expedient means of detecting optimal intubating conditions (ie, paralysis).

Methods: A prospective observational cohort study of consecutively enrolled patients was conducted from April to June 2016 at an academic, urban, level 1 trauma centre in New York City. Read More

Acad Emerg Med 2018 01 3;25(1):94-98. Epub 2017 Nov 3.

Pathology North, Tamworth Rural Referral Hospital, Tamworth, NSW, Australia.

Objective: This study was a prospective, randomized controlled trial of rapid sequence intubation (RSI) with cricoid pressure (CP) within the emergency department (ED). The primary aim of the study was to examine the link between ideal CP and the incidence of aspiration.

Method: Patients > 18 years of age undergoing RSI in the ED of two hospitals in New South Wales, Australia, were randomly assigned to receive measured CP using weighing scales to target the ideal CP range (3. Read More

J Clin Monit Comput 2018 Aug 27;32(4):687-691. Epub 2017 Sep 27.

Department of Anesthesiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, 960-1295, Japan.

The oxygen reserve index (ORi™) is a new parameter for monitoring oxygen reserve noninvasively. The aim of this study was to examine the usefulness of ORi for rapid sequence induction (RSI). Twenty adult patients who were scheduled for surgical procedures under general anesthesia were enrolled. Read More

Am J Emerg Med 2018 Feb 21;36(2):197-201. Epub 2017 Jul 21.

Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:

Objectives: To compare the effects of intravenous fentanyl and lidocaine on hemodynamic changes following endotracheal intubation in patients requiring Rapid Sequence Intubation (RSI) in the emergency department (ED).

Methods: A single-centered, prospective, simple non-randomized, double-blind clinical trial was conducted on 96 patients who needed RSI in Edalatian ED. They were randomly divided into three groups (fentanyl group (F), lidocaine group (L), and fentanyl plus lidocaine (M) as our control group). Read More

Emerg Med J 2017 Nov 16;34(11):739-743. Epub 2017 Aug 16.

Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, Arizona, USA.

Objectives: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing.

Methods: This was a retrospective cohort study conducted in a tertiary care academic ED. Read More

Aust J Rural Health 2018 Feb 10;26(1):48-55. Epub 2017 Aug 10.

Emergency Department, Whanganui District Hospital, Whanganui, New Zealand.

Objective: To describe the practice and procedure of emergency intubation in Whanganui Emergency Department, New Zealand and determine whether intubation can be carried out effectively in the rural setting.

Method: A prospective observational study using the Australia and New Zealand Airway Registry proforma to collect data on the indication, lead intubator, first-pass success rate and peri-procedural complications. Data were also collected on whether a formal airway assessment was carried out and whether a checklist was used. Read More

Acad Emerg Med 2017 11 13;24(11):1395-1404. Epub 2017 Oct 13.

Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ.

Acad Emerg Med 2017 11 23;24(11):1387-1394. Epub 2017 Sep 23.

Department of Emergency Medicine, Weill Medical College of Cornell University, Lincoln Medical Center, Bronx, NY.

Objectives: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. Read More

Eur J Anaesthesiol 2017 09;34(9):623-627

From the Department of Anesthesiology and Intensive Care Medicine, University Hospital of Rostock (MS, IP, CH, GR, GN-S, TM); and Fraunhofer Institut for Cell Therapy and Immunology, Project Group EXIM, Rostock, Germany (MS, MM).

Background: The development of liver failure is a major problem in critically ill patients. The hepatotoxicity of many drugs, as one important reason for liver failure, is poorly screened for in human models. Rocuronium and succinylcholine are neuromuscular blocking agents used for tracheal intubation and for rapid-sequence induction. Read More

Crit Care 2017 Jul 31;21(1):192. Epub 2017 Jul 31.

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.

Background: Pre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. Despite a wide range of publications in the field, it is debated whether the intervention is associated with a favourable outcome, when compared to more conservative airway measures.

Methods: A systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation. Read More