Annals of emergency medicine
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The Greater Sydney Area Helicopter Emergency Medical Service undertakes in excess of 2,500 physician/paramedic out-of-hospital and interhospital retrievals each year, of which 8% require intubation. Emergency anesthesia of critically ill patients is associated with complications, including hypoxia. In July 2011, the service introduced apneic oxygenation with nasal cannulae to its emergency anesthesia standard operating procedure to reduce rates of desaturation during rapid sequence intubation. We evaluate the association between the introduction of apneic oxygenation and incidence of desaturation during rapid sequence intubation in both out-of-hospital and interhospital retrievals. ⋯ Introduction of apneic oxygenation was associated with decreased incidence of desaturation in patients undergoing rapid sequence intubation.
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Multicenter Study Observational Study
Delayed Sequence Intubation: A Prospective Observational Study.
We investigate a new technique for the emergency airway management of patients with altered mental status preventing adequate preoxygenation. ⋯ Delayed sequence intubation could offer an alternative to rapid sequence intubation in patients requiring emergency airway management who will not tolerate preoxygenation or peri-intubation procedures. It is essentially procedural sedation, with the procedure being preoxygenation. Delayed sequence intubation seems safe and effective for use in emergency airway management.