An observation study of rapid sequence, awake and sedation-only intubations in an emergency department in Thai patients.
BACKGROUND
Rapid Sequence Intubation (RSI) in emergency departments (EDs) is recognized as a cornerstone of emergency airway management in developed countries. In Thailand, emergency medicine is a new specialty and RSI is a novel method for patients in EDs. The observation of RSI and two former methods in EDs were carried out to assess whether RSI was more successful and had lower immediate complication in Thai patients or not.


METHODS
The authors performed a retrospective study. The emergency airway management records were reviewed and analyzed for the primary outcome. The primary outcome included the overall success rate, the success rate within 1 attempt, the success rate within 2 attempts, and the overall immediate complication rates for orotracheal intubations.


RESULTS
Seventy-eight patients were included in the present study. The overall success rate, the success rate within 1 attempt and the success rate within 2 attempts of the RSI group were statistically significantly higher and the overall immediate complication rate of RSI group was statistically significantly lower than awake and sedation-only intubation groups. No incidence of severe arrhythmia, cricothyroidotomy, and cardiac arrest during the intubation were found.


CONCLUSIONS
RSI in EDs was more successful in selected patients compared to the two former methods in emergency airway management in Thai patients. The clinical outcome especially that resulted from the complication needs further study.
Trakulsrichai
Satariya
S
Emergency Department, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand. Satariya_tra@hotmail.com
Sundarathiti
Petchara
P
Chalermdamrichai
Phanorn
P
Palasatien
Isares
I
Rattanasiri
Sasivimol
S
Chatchaipun
Porntip
P
Hathirat
Sant
S
D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D016292:Procedural Sedation / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005045:Etomidate / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D013390:Succinylcholine / Q000627:therapeutic use; D013785:Thailand; D013997:Time Factors
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D005283:Fentanyl; D005045:Etomidate