title: The use of rapid sequence intubation by ambulance paramedics for patients with severe head injury.
abstract: 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.
authors.affiliation: Air Ambulance Victoria, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. stephen.bernard@dhs.vic.gov.au
authors.forename: Stephen
authors.initials: S
authors.lastname: Bernard
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.forename: Shane
authors.initials: S
authors.lastname: Foster
authors.forename: Phillip
authors.initials: P
authors.lastname: Hogan
authors.forename: Ian
authors.initials: I
authors.lastname: Patrick
mesh_terms: 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
chemical_list: D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine