Document Detail


Incidence of adverse events during prehospital rapid sequence intubation: a review of one year on the London Helicopter Emergency Medical Service.
MedLine Citation:
PMID:  18301219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To establish the incidence of hypoxemia and hypotension during prehospital rapid sequence intubation (RSI) in trauma patients attended by the London Helicopter Emergency Medical Service (HEMS) and to compare it with historical control data from published studies of both hospital and prehospital RSI. METHODS: A retrospective observational study during a 12-month period of London HEMS. All mission reports from the period March 1, 2003 to February 28, 2004 were reviewed and all intubations involving the use of drugs were included in the analysis. Measurements of oxygen saturation (SpO2) and systolic blood pressure (SBP) were obtained from the printed record produced by the portable monitor. RESULTS: During the 12-month period 244 RSIs were performed. Completed SpO2 data were available on 175 patients (71.7%), and of those 32 (18.3%) experienced hypoxemia (SpO2 <90%, or >10% fall if initial SpO2 <90%). Completed SBP data were available for 192 patients (79.1%), and of those 25 (13%) experienced hypotension (SBP <90 mm Hg or >10 mm Hg fall if initial SBP <90 mm Hg). No patients developed both hypoxemia and hypotension. CONCLUSIONS: Rates of hypoxemia and hypotension during prehospital RSI performed by London HEMS are relatively low. They are less than that found in previous studies of prehospital RSI and are similar to those reported in studies of in-hospital emergency RSI undertaken in the emergency department or ward setting. We therefore conclude that prehospital RSI has an acceptably low complication rate when performed by appropriately trained personnel.
Authors:
Alastair Newton; Andrew Ratchford; Ifty Khan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  64     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-27     Completed Date:  2008-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  487-92     Citation Subset:  AIM; IM    
Affiliation:
Emergency Department, St Thomas' Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aircraft
Anoxia / epidemiology,  etiology*
Blood Pressure
Emergency Medical Services*
Humans
Hypotension / epidemiology,  etiology*
Incidence
Intubation, Intratracheal / adverse effects*
London
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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