The use of rapid sequence intubation by ambulance paramedics for patients with severe head injury.
OBJECTIVE
To determine the effects of rapid sequence intubation in patients with severe head injury performed by paramedics on a helicopter emergency medical service.


METHODS
The patient care records for patients with severe head injury who underwent rapid sequence intubation between November 1999 and February 2002 (inclusive) were examined. Data were extracted on the demographics of the patients, as well as the physiological changes before and after rapid sequence intubation.


RESULTS
There were 122 patients with severe head injury evaluated at the scene during the study period. Rapid sequence intubation was attempted in 110 patients and was successful in 107 (97%). Intubation was associated with improvements in systolic blood pressure, oxygen saturation and end-tidal carbon dioxide levels, compared with baseline levels.


CONCLUSIONS
Rapid sequence intubation in patients with severe head injury may be safely undertaken by helicopter-based ambulance paramedics and is associated with improvements in oxygenation, ventilation and blood pressure. Further studies of this skill undertaken by road-based paramedics are warranted.
Bernard
Stephen
S
Air Ambulance Victoria, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. stephen.bernard@dhs.vic.gov.au
Smith
Karen
K
Foster
Shane
S
Hogan
Phillip
P
Patrick
Ian
I
D000328:Adult; D017732:Air Ambulances; D000704:Analysis of Variance; D006259:Craniocerebral Trauma / Q000628:therapy*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D017751:Safety Management; D013390:Succinylcholine / Q000627:therapeutic use; D016896:Treatment Outcome; D014739:Victoria
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine