Comparison of Etomidate and Ketamine for Induction During Rapid Sequence Intubation of Adult Trauma Patients

Upchurch, Cameron; Grijalva, Carlos G.; Russ, Stephan; Collins, Sean P.; Semler, Matthew W.; Rice, Todd W.; Liu, Dandan; Ehrenfeld, Jesse M.; High, Kevin; Barrett, Tyler W.; McNaughton, Candace D.; Self, Wesley H.

doi:10.1016/j.annemergmed.2016.08.009

Cited by 75 publications

(58 citation statements)

References 42 publications

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“…We have previously validated these data-collection techniques for relevant data points. 15,22,23 Coexisting conditions at baseline were summarized with the Elixhauser Comorbidity Index score. 24 …”

Section: Methodsmentioning

confidence: 99%

Balanced Crystalloids versus Saline in Noncritically Ill Adults

Semler

Self²,

Wanderer³

et al. 2018

N Engl J Med

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726

418

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BACKGROUND Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). METHODS We conducted a single-center, pragmatic, multiple-crossover trial comparing balanced crystalloids (lactated Ringer’s solution or Plasma-Lyte A) with saline among adults who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU. The type of crystalloid that was administered in the emergency department was assigned to each patient on the basis of calendar month, with the entire emergency department crossing over between balanced crystalloids and saline monthly during the 16-month trial. The primary outcome was hospital-free days (days alive after discharge before day 28). Secondary outcomes included major adverse kidney events within 30 days — a composite of death from any cause, new renal-replacement therapy, or persistent renal dysfunction (defined as an elevation of the creatinine level to ≥200% of baseline) — all censored at hospital discharge or 30 days, whichever occurred first. RESULTS A total of 13,347 patients were enrolled, with a median crystalloid volume administered in the emergency department of 1079 ml and 88.3% of the patients exclusively receiving the assigned crystalloid. The number of hospital-free days did not differ between the balanced-crystalloids and saline groups (median, 25 days in each group; adjusted odds ratio with balanced crystalloids, 0.98; 95% confidence interval [CI], 0.92 to 1.04; P = 0.41). Balanced crystalloids resulted in a lower incidence of major adverse kidney events within 30 days than saline (4.7% vs. 5.6%; adjusted odds ratio, 0.82; 95% CI, 0.70 to 0.95; P = 0.01). CONCLUSIONS Among noncritically ill adults treated with intravenous fluids in the emergency department, there was no difference in hospital-free days between treatment with balanced crystalloids and treatment with saline.

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Section: Methodsmentioning

confidence: 99%

Balanced Crystalloids versus Saline in Noncritically Ill Adults

Semler

Self²,

Wanderer³

et al. 2018

N Engl J Med

Self Cite

726

418

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“… Ketamine has a preferable cardiorespiratory safety profile . Ketamine has been considered contraindicated in patients with head trauma due to the concern of increasing intracranial pressure, but the current evidence to refute ketamine use is not strong . Reports have suggested that ketamine does not reduce regional glucose metabolism or augment oxygen consumption but could benefit patients with an intracranial injury by a catecholamine‐mediated increase in cerebral perfusion.…”

Section: Special Circumstance: Patients With Traumamentioning

confidence: 99%

Advancing emergency airway management practice and research

Goto

Hagiwara

et al. 2019

Acute Medicine & Surgery

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Emergency airway management is one of the vital resuscitative procedures undertaken in the emergency department (ED). Despite its clinical and research importance in the care of critically ill and injured patients, earlier studies have documented suboptimal intubation performance and high adverse event rates with a wide variation across the EDs. The optimal emergency airway management strategies remain to be established and their dissemination to the entire nation is a challenging task. This article reviews the current published works on emergency airway management with a focus on the use of airway management algorithms as well as the importance of first‐pass success and systematic use of rescue intubation strategies. Additionally, the review summarizes the current evidence for each of the important airway management processes, such as assessment of the difficult airway, preparation (e.g., positioning and oxygenation), intubation methods (e.g., rapid sequence intubation), medications (e.g., premedications, sedatives, and neuromuscular blockades), devices (e.g., direct and video laryngoscopy and supraglottic devises), and rescue intubation strategies (e.g., airway adjuncts and rescue intubators), as well as the airway management in distinct patient populations (i.e., trauma, cardiac arrest, and pediatric patients). Well‐designed, rigorously conducted, multicenter studies that prospectively and comprehensively characterize emergency airway management should provide clinicians with important opportunities for improving the quality and safety of airway management practice. Such data will not only advance research into the determination of optimal airway management strategies but also facilitate the development of clinical guidelines, which will, in turn, improve the outcomes of critically ill and injured patients in the ED.

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“… 39 Interventions can be assessed and judged for usefulness, deployment, and retention within the armamentarium of initial trauma care. Rapid sequence intubation continues to be refined 40 and anatomic positioning for needle decompression has been altered. 41 The utility, timing, and usefulness of diagnostic peritoneal lavage, CT, ultrasound, pericardiocentesis, emergency thoracotomy, and balloon occlusion of the aorta continue to be evaluated.…”

Section: Procedural Interventionsmentioning

confidence: 99%

History and significance of the trauma resuscitation flow sheet

Dunn

Schroeppel

Metzler

et al. 2018

Trauma Surg Acute Care Open

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There is little to no written information in the literature regarding the origin of the trauma flow sheet. This vital document allows programs to evaluate initial processes of trauma care. This information populates the trauma registry and is reviewed in nearly every Trauma Process Improvement and Patient Safety conference when discerning the course of patient care. It is so vital, a scribe is assigned to complete this documentation task for all trauma resuscitations, and there are continual process improvement efforts in trauma centers across the nation to ensure complete and accurate data collection. Indeed, it is the single most important document reviewed by the verification committee when evaluating processes of care at site visits. Trauma surgeons often overlook its importance during resuscitation, as recording remains the domain of the trauma scribe. Yet it is the first document scrutinized when the outcome is less than what is expected. The development of the flow sheet is not a result of any consensus statement, expert work group, or mandate, but a result of organic evolution due to the need for relevant and better data. The purpose of this review is to outline the origin, importance, and critical utility of the trauma flow sheet.

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Comparison of Etomidate and Ketamine for Induction During Rapid Sequence Intubation of Adult Trauma Patients

Cited by 75 publications

References 42 publications

Balanced Crystalloids versus Saline in Noncritically Ill Adults

Balanced Crystalloids versus Saline in Noncritically Ill Adults

Advancing emergency airway management practice and research

History and significance of the trauma resuscitation flow sheet

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