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Emergency Medicine Journal 2002;19:109-113; doi:10.1136/emj.19.2.109
© 2002 BMJ Publishing Group Ltd and the College of Emergency Medicine.
Emerg Med J 2002; 19:109-113
© 2002 the Emergency Medicine Journal

ORIGINAL ARTICLE

Rapid sequence induction in the emergency department: a strategy for failure

S D Carley, C Gwinnutt, J Butler, I Sammy, P Driscoll

Hope Hospital, Salford, UK

Correspondence to:
Correspondence to:
Dr S D Carley, Department of Accident and Emergency Medicine, Royal Bolton Hospital, Minerva Lane, Bolton, Lancashire BL4 0JR, UK;
s.carley{at}btinternet.com

Background: Rapid sequence induction (RSI) is increasingly used by emergency physicians in the emergency department. A feared complication of the technique is the inability to intubate and subsequently ventilate the patient. Current drills based on anaesthetic practice may be unsuitable for use in the emergency department.

Objective: To construct a drill for failed adult intubation in the emergency department.

Methods: Literature review and consensus knowledge.

Results: A drill for failed adult intubation in the emergency department is given.

Summary: Failure to intubate following RSI in the emergency department is a feared complication. Practitioners must have a predetermined course of action to cope with this event. The guidelines presented here are tailored for use by the emergency physician.

Keywords: rapid sequence induction; failed intubation; laryngoscopy

Abbreviations: RSI, rapid sequence induction; LMA, laryngeal mask airway


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This article has been cited by other articles:

  • Ollerton, J E, Parr, M J A, Harrison, K, Hanrahan, B, Sugrue, M (2006). Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review. Emerg. Med. J. 23: 3-11 [Abstract] [Full Text]  
  • Graham, C. A (2005). Emergency department airway management in the UK. JRSM 98: 107-110 [Full Text]  
  • Carley, S., Gwinnutt, C. (2004). Stepwise airway management in the trauma patient. Trauma 6: 177-185 [Abstract]  

eLetters:

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RSI by non-anaesthetists in the UK - lower incidence of cricothyrotomy than in the US
Cliff Reid, et al.
EMJ Online, 3 Apr 2002 [Full text]
Failed intubation drill: a necessity
Fiona J Macfarlane
EMJ Online, 28 May 2002 [Full text]
RSI and crichothyrotomy success rates
Dominique S Brookes
EMJ Online, 4 Jan 2005 [Full text]

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