Safety of rapid sequence intubation in an emergency training network

Objective Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence. Methods Prospe...

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Bibliographic Details
Published in:Emergency medicine Australasia 2021-10, Vol.33 (5), p.857-867
Main Authors: Grant, Steven, Pellatt, Richard AF, Shirran, Mark, Sweeny, Amy L, Perez, Siegfried R, Khan, Faisal, Keijzers, Gerben
Format: Article
Language:English
Subjects:
airway
intubation
rapid sequence intubation
safety
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Summary:Objective Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence. Methods Prospective observational study of RSIs performed in the EDs of two Queensland hospitals between January 2014 and December 2016. Data collected included: first‐pass success (FPS), predicted difficulty, indication for intubation, drugs used, positioning, number of attempts, checklist use and complications. Descriptive statistics and multivariable modelling were used to describe differences in FPS, and complications. Results Six hundred and fifty‐five patients underwent RSI with FPS of 86.6%. Complications were reported in 15.9%, mainly hypotension (10.9%) and desaturation (4.0%). FPS improved with bougie use (88.9% vs 73.0% without bougie, P 
ISSN:1742-6731
1742-6723
DOI:10.1111/1742-6723.13742