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Rapid Sequence Intubation: Overview and Myths Versus Facts

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Annual Update in Intensive Care and Emergency Medicine 2011

Part of the book series: Annual Update in Intensive Care and Emergency Medicine 2011 ((AUICEM,volume 1))

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Abstract

Endotracheal intubation is one of the skills in which emergency medicine, anesthesiology, and critical care physicians take pride. Outside the operating room (OR), it is performed daily in a variety of settings including pre-hospital, emergency departments (ED), and intensive care units (ICU). For emergency medicine physicians and intensivists, this was not the case as late as the 1970s, when medications used in the OR for intubation were not yet available. In 1979, Taryle and colleagues reported that complications occurred in 24 of 43 patients intubated in a university hospital ED. They called for improved training in endotracheal intubation outside of the OR, as well as use of OR approaches such as sedation and muscle relaxation [1]. The answer to this call came with expansion of training in intubation and introduction of rapid sequence intubation outside of the OR.

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References

  1. Taryle DA, Chandler JE, Good JT Jr, Potts DE, Sahn SA (1979) Emergency room intubations—complications and survival. Chest 75: 541–543

    Article  PubMed  CAS  Google Scholar 

  2. Hopson LR, Dornen SC (2004) Pharmacologic adjuncts to intubation. In: Roberts JR, Hedges, JR (ed) Clinical Procedures in Emergency Medicine, 4th edn. Saunders Elsevier, Philadelphia, pp 100–114

    Google Scholar 

  3. Walls R, Murphy (2008) Rapid sequence intubation. In: Walls RM (ed) Manual of Emergency Airway Management, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 24–35

    Google Scholar 

  4. Vrocher D, Hopson LR (2004) Basic airway management and decision-making. In: Roberts JR, Hedges, JR (ed) Clinical Procedures in Emergency Medicine, 4th edn. Saunders Elsevier, Philadelphia, pp 53–68

    Google Scholar 

  5. Field J, Hazinski MF, Gilmore D (2004) Handbook of Emergency Cardiovascular Care for Healthcare Providers. American Heart Association, Dallas

    Google Scholar 

  6. Fakhry SM, Scanlon JM, Robinson L, et al (2006) Prehospital rapid sequence intubation for head trauma: conditions for a successful program. J Trauma 60: 997–1001

    Article  PubMed  Google Scholar 

  7. Pearson S (2003) Comparison of intubation attempts and completion times before and after the initiation of a rapid sequence intubation protocol in an air medical transport program. Air Med J 22: 28–33

    Article  PubMed  Google Scholar 

  8. Davis DP, Hoyt DB, Ochs M, et al (2003) The effect of paramedic rapid sequence intubation on outcome in patients with severe traumatic brain injury. J Trauma 54: 444–453.

    Article  PubMed  Google Scholar 

  9. Caro D, Bush S (2008) Pretreatment agents. In: Walls RM (ed) Manual of Emergency Airway Management, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 222–233

    Google Scholar 

  10. King BD, Harris LC Jr, Greifenstein FE, Elder JD Jr, Dripps RD (1951) Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anesthesia. Anesthesiology 12: 556–566

    Article  PubMed  CAS  Google Scholar 

  11. Cottrell JE, Hartung J, Giffin JP, Shwiry, B (1983) Intracranial and hemodynamic changes after succinylcholine administration in cats. Anesth Analg 62: 1006–1009

    Article  PubMed  CAS  Google Scholar 

  12. Robinson J, Preston D, Shapiro B (2008) Proximal, distal, and generalized weakness. In: Bradley W, Daroff R, Fenichel G, Jankovic J (ed) Neurology in Clinical Practice, 5th edn. Butterworth Heinemann Elsevier, Philadelphia, pp 366–383

    Google Scholar 

  13. Schreiber JU, Lysakowski C, Fuchs-Buder T, Tramèr MR (2005) Prevention of succinylcholine-induced fasciculation and myalgia: a meta-analysis of randomized trials. Anesthesiology 103: 877–84.

    Article  PubMed  CAS  Google Scholar 

  14. Koenig KL (1992) Rapid-sequence intubation of head trauma patients: prevention of fasciculations with pancuronium versus minidose succinylcholine. Ann Emerg Med Aug; 21: 929–32

    Article  CAS  Google Scholar 

  15. Yukioka H, Hayashi M, Terai T, Fujimori M (1993) Intravenous lidocaine as a suppressant of coughing during tracheal intubation in elderly patients. Anesth Analg 77: 309–312

    PubMed  CAS  Google Scholar 

  16. Warner LO, Balch DR, Davidson PJ (1997) Is intravenous lidocaine an effective adjuvant for endotracheal intubation in children undergoing induction of anesthesia with halothane-nitrous oxide?. J Clin Anesth 9: 270–274

    Article  PubMed  CAS  Google Scholar 

  17. Robinson N, Clancy M (2001) In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature. Emerg Med J 18: 453–457

    Article  PubMed  CAS  Google Scholar 

  18. Butler J, Jackson R (2002) Towards evidence based emergency medicine: best BETs from Manchester Royal Infirmary. Lignocaine premedication before rapid sequence induction in head injuries. Emerg Med J 19: 554

    Article  PubMed  Google Scholar 

  19. Brooks D, Anderson CM, Carter MA, et al (2001) Clinical practice guidelines for suctioning the airway of the intubated and nonintubated patient. Can Respir J 8: 163–181

    PubMed  CAS  Google Scholar 

  20. Kelly MA, Finer NN (1984) Nasotracheal intubation in the neonate: physiologic responses and effects of atropine and pancuronium. J Pediatr 105: 303–309

    Article  PubMed  CAS  Google Scholar 

  21. Desalu I, Kushimo OT, Bode CO (2005) A comparative study of the hemodynamic effects of atropine and glycopyrolate at induction of anesthesia in children.West Afr J Med 24: 115–159

    PubMed  CAS  Google Scholar 

  22. McAulife G, Bissonnette B, Boutin C (1995) Should the routine use of Atropine before succinylcholine in children be reconsidered?. Can J Anaesth 42: 724–729

    Article  Google Scholar 

  23. McCauley CS, Boller LR (1988) Bradycardic responses to endotracheal suctioning. Crit Care Med 16: 1165–1166

    Article  PubMed  CAS  Google Scholar 

  24. Søensen M, Engbaek J, Viby-Mogensen J, Guldager H, Molke Jensen F (1984) Bradycardia and cardiac asystole following a single injection of suxamethonium. Acta Anaesthesiol Scand 28: 232–235

    Article  Google Scholar 

  25. Sellick BA (1961) Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia. Lancet 2: 404–406

    Article  PubMed  CAS  Google Scholar 

  26. Butler J, Sen A (2005) Best evidence topic report. Cricoid pressure in emergency rapid sequence induction. Emerg Med J 22: 815–816

    Article  PubMed  Google Scholar 

  27. Allman KG (1995) The effect of cricoid pressure application on airway patency. J Clin Anesth 7: 197–199

    Article  PubMed  CAS  Google Scholar 

  28. Brimacombe JR, Berry AM (1997) Cricoid pressure. Can J Anaesth 44: 414–425

    Article  PubMed  CAS  Google Scholar 

  29. Smith KJ, Dobranowski J, Yip G, Dauphin A, Choi PT (2003) Cricoid pressure displaces the esophagus: an observational study using magnetic resonance imaging. Anesthesiology 99: 60–64

    Article  PubMed  Google Scholar 

  30. Bergen JM, Smith DC (1997) A review of etomidate for rapid sequence intubation in the emergency department. J Emerg Med 15: 221–230

    Article  PubMed  CAS  Google Scholar 

  31. Jabre P, Combes X, Lapostolle F, et al (2009) Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet 374: 293–300

    Article  PubMed  CAS  Google Scholar 

  32. Cuthbertson BH, Sprung CL, Annane D, et al (2009) The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock. Intensive Care Med 35: 1868–1876

    Article  PubMed  CAS  Google Scholar 

  33. Dmello D, Taylor S, O’brien J, Matuschak GM (2010) Outcomes of etomidate in severe sepsis and septic shock. Chest 138: 1327–1332

    Article  PubMed  Google Scholar 

  34. Ray DC, McKeown DW (2007) Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Crit Care 11: R56

    Article  PubMed  Google Scholar 

  35. Halldin M, Wahlin A (1959) Effect of succinylcholine on the intraspinal fluid pressure. Acta Anaesthesiol Scand 3: 155–161

    Article  PubMed  CAS  Google Scholar 

  36. Minton MD, Grosslight K, Stirt JA, Bedford RF (1986) Increases in intracranial pressure from succinylcholine: prevention by prior nondepolarizing blockcade. Anesthesiology 65: 165–169

    Article  PubMed  CAS  Google Scholar 

  37. Kovarick WD, Mayberg TS, Lam AM, Mathisen TL, Winn HR (1994) Succinylcholine does not change intracranial pressure, cerebral blood flow velocity or the electroencephalogram in patients with neurologic injury. Anesth Analg 78: 469–473

    Google Scholar 

  38. McLeskey CH, Cullen BF, Kennedy RD, Galindo A (1974) Control of cerebral perfusion pressure during induction of anesthesia in high-risk neurosurgical patients. Anesth Analg 53: 985–992

    Article  PubMed  CAS  Google Scholar 

  39. Jeevendra Martyn JA, Richtsfeld M (2006) Succinylcholine-induced hyperkalemia in acquired pathological states: etiologic factors and molecular mechanisms. Anesthsiology 104: 158–169

    Article  Google Scholar 

  40. Jeevendra Martyn JA, Fukushima Y, Chon JY, Yong HS (2006) Muscle relaxants in burns, trauma, and critical illness. Int Anesthesiol Clin 44: 123–143

    Article  PubMed  CAS  Google Scholar 

  41. Orebaugh SL (1999) Succinylcholine: adverse effects and alternatives in emergency medicine. Am J Emerg Med 17: 715–721.

    Article  PubMed  CAS  Google Scholar 

  42. Caro DA, Tyler KR (2008) Sedative induction agents. In: Walls RM (ed) Manual of Emergency Airway Management, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp 235–245

    Google Scholar 

  43. Jensen S, Schou-Olsen A, Huttel MS (1982) Use of midazolam as an induction agent: comparison with thiopentone. Br J Anaesth 54: 605–607

    PubMed  CAS  Google Scholar 

  44. Sagarin MJ, Barton ED, Sakles JC, et al (2003) Under dosing of midazolam in emergency endotracheal intubation. Acad Emerg Med 10: 329–338

    Article  PubMed  Google Scholar 

  45. Sivilotti ML, Ducharme J (1998) Randomized double-blind study on sedatives and hemodynamicsduring rapid sequence intubation in the emergency department: The SHRED study. Ann Emerg Med 31: 313–324

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Critical Care Medicine, Cooper University Hospital, One Cooper Plaza 394 Dorrance, Camden, NJ, 08103, USA

    M. F. Yazbeck & R. P. Dellinger

  2. Medical School, UMDNJ, Robert Wood Johnson, 401 Haddon Avenue, Camden, NJ, 08103, USA

    J. Finkelstein

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  1. M. F. Yazbeck
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  2. J. Finkelstein
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  3. R. P. Dellinger
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Yazbeck, M.F., Finkelstein, J., Dellinger, R.P. (2011). Rapid Sequence Intubation: Overview and Myths Versus Facts. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2011. Annual Update in Intensive Care and Emergency Medicine 2011, vol 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18081-1_12

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  • DOI: https://doi.org/10.1007/978-3-642-18081-1_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18080-4

  • Online ISBN: 978-3-642-18081-1

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