Bag‐mask ventilation in rapid sequence induction

Brown, Jan; Werrett, G.

doi:10.1111/j.1365-2044.2009.05972.x

Cited by 18 publications

(7 citation statements)

References 7 publications

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“…Gentle intermittent positive pressure ventilation before rapid sequence intubation has been recommended in recent publications, especially in a specific group of patients such as obese, pregnant, paediatric and critically ill patients. [ 7 ] If the tracheal intubation attempt fails, severe hypoxia could result even before starting the failed intubation protocol. Pre-emptive mask ventilation employing low inspiratory pressures (<20 cm H 2 O) before tracheal intubation may be deemed reasonable, if not imperative, in these situations.…”

Section: Discussionmentioning

confidence: 99%

A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury

et al. 2016

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Background and Aims:Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation (RSI) in head injury patients among a population of anaesthesiologists from South India.Methods:A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists’ South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury. Participants were requested to indicate their practices for RSI technique for a head-injured patient upon arrival at the Emergency Medical Services department of their hospital.Results:The total response rate was 56.9% (530/932). Of the total respondents, 35% of the clinicians used cricoid pressure routinely, most respondents (68%) stated that they pre-oxygenate the patients for about 3 min prior to RSI, thiopentone (61%) and propofol (34%) were commonly used prior to intubation. Rocuronium was the muscle relaxant of choice for RSI among the majority (44%), compared to succinylcholine (39%). Statistical analyses were performed after the initial entry onto a spreadsheet. Data were summarised descriptively using frequency distribution.Conclusion:In a rapid sequence intubation situation, the practice differed significantly among anaesthesiologists. Owing to disagreements and paucity of evidence-based data regarding the standards of RSI, it is apparent that RSI practice still has considerable variability in clinical practice.

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Section: Discussionmentioning

confidence: 99%

A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury

et al. 2016

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“…A bag-valve mask (BVM) is a frequently used, portable, and economical ventilation device for improving patients' oxygen saturation before intubation in the ED. The advantage of using BVM ventilation in different scenarios has been shown in multiple studies [7][8][9]. Additionally, a new randomized, controlled study of BVM ventilation demonstrated a decreased incidence of desaturation during intubation using BVM while not increasing the risk of aspiration or hypotension compared with no BVM ventilation [10,11].…”

Section: Background and Rationale {6a}mentioning

confidence: 97%

Can bag-valve mask ventilation with positive end-expiratory pressure reduce hypoxia during intubation? A prospective, randomized, double-blind trial

Dai

Walline

et al. 2021

Trials

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Background Hypoxia is one of the life-threatening complications of endotracheal intubation. Supplemental oxygen and ventilation play a vital role in preventing hypoxia. Bag-valve mask (BVM) ventilation is frequently used before intubation, and its ability to improve oxygenation was recently confirmed. It is still unclear if positive end-expiratory pressure (PEEP) added to BVM ventilation can further reduce hypoxia during intubation. Methods This will be a prospective, randomized, double-blind trial to determine if PEEP combined with BVM ventilation can reduce the incidence of hypoxia during intubation compared with conventional BVM ventilation. The lowest oxygen saturation and incidence of complications will be compiled to verify the comparative effectiveness and safety of the two groups. Discussion BMV ventilation with PEEP is hoped to further reduce the incidence of hypoxia during intubation. Trial registration Chinese Clinical Trial Registry ChiCTR2000035156. Registered on August 2, 2020. It had begun enrollment after passing ethical review but before registration.

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“…33 Ventilation just before intubation is also deemed necessary when NMBA used is not succinylcholine, because the onset and duration of action will be longer. 53 Gentle mask ventilation (inspiratory pressure < 20 cmH 2 O) is suggested to be acceptable before intubation. 54 Indeed even without application of CP, providing bagmask ventilation with inspiratory pressure < 15 cmH 2 O did not cause gastric inflation.…”

Section: The Ban Of Using Positive Pressure Ventilation (Ppv) Controv...mentioning

confidence: 99%

Rapid sequence induction/intubation controversies

Kriswidyatomo

Paramitha

2020

Hong Kong Journal of Emergency Medicine

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Backgrounds: Since its first definition and publication on 1970, Rapid Sequence Induction / Intubation (RSI) technique has been accepted globally as the “standard” for doing rapid intubation after induction of anesthesia for patients with high risk of aspiration, especially in emergency situation. However, this technique is not so much a “standard” as there are numerous variations on its practice based on national surveys. Anesthesia providers have their own opinions on the practice of RSI components which need to be discussed to assess their advantages and disadvantages, while there has been no review article which discussed these controversies in the last ten years. Objectives: To review the technique differences within RSI protocols. Methods: Online databases were searched, including MEDLINE and COCHRANE for each step in the original RSI protocol using keywords such as: “rapid sequence induction” or “rapid sequence intubation” or “RSI” and “controversies” or “head position” or “cricoid pressure” or “neuromuscular blocking agent” or “NMBA” or positive pressure ventilation” or “PPV”; and so on. Articles were then sorted out based on relevancy. Results and conclusion: Supported by new evidence, RSI practices may differ in: the positioning of patient, choices of induction agent, application of cricoid pressure, choices of neuromuscular blocking agent, and the use of positive pressure ventilation. A more updated and standardized guideline should be established by referring and evaluating to these controversies.

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Bag‐mask ventilation in rapid sequence induction

Cited by 18 publications

References 7 publications

A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury

A survey of a population of anaesthesiologists from South India regarding practices for rapid sequence intubation in patients with head injury

Can bag-valve mask ventilation with positive end-expiratory pressure reduce hypoxia during intubation? A prospective, randomized, double-blind trial

Rapid sequence induction/intubation controversies

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