Rapid sequence intubation for pediatric emergency airway management

Sagarin, Mark J.; Chiang, Vincent W.; Sakles, John C.; Barton, Erik D.; Wolfe, Richard E.; Vissers, Robert J.; Walls, Ron M.

doi:10.1097/00006565-200212000-00004

Cited by 194 publications

(145 citation statements)

References 20 publications

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…2,[7][8][9][10] In a multi-center observational study Sagarin et al found that of 156 pediatric intubations, 81% were rapid sequence intubations, 13% were without medication and 6% used sedation without neuromuscular blockade. 11 These results are surprising since they are not the same as those found at our service (work in progress at two pediatric ICUs in Porto Alegre, shows a predominance of sedation without neuromuscular blocking agent).…”

Section: Introductioncontrasting

confidence: 53%

Acesso rápido à via aérea

Amantéa

Piva²,

Zanella³

et al. 2003

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Section: Introductioncontrasting

confidence: 53%

Acesso rápido à via aérea

Amantéa

Piva²,

Zanella³

et al. 2003

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

“…[8][9][10] The lowest success rate (67%) was, as expected, in the resident group; however, this rate was similar to the rate of resident success previously described. 11,12 The high success rate (100%) of both PEM and PICU fellows is likely due to the anesthesia rotations that are mandatory and usually completed early in fellowship. The success rate of PEM attending staff (76%) was significantly lower than the published success of emergency medicine attending staff (98%).…”

Section: Discussionmentioning

confidence: 99%

Resuscitation interventions in a tertiary level pediatric emergency department: implications for maintenance of skills

Guilfoyle

Milner

Kissoon

2011

CJEM

View full text Add to dashboard Cite

Objective: To describe the frequency and proportion of successful resuscitation interventions in a pediatric emergency department (PED). Methods and Material: This was a retrospective chart review of children at the BC Children's Hospital (BCCH) PED who were admitted to the BCCH pediatric intensive care unit (PICU) in 2004 and 2005. Demographic data, diagnosis, and resuscitation interventions in the PED and within the first 24 hours of PICU admission were recorded. The training of the operator and the number of attempts needed were also recorded. Results: There were 75,133 PED visits; 304 of 329 (92.4%) who met inclusion criteria were reviewed. Diagnoses included respiratory distress (n 5 115, 35%), trauma (n 5 50, 15%), sepsis (n 5 36, 11%), seizures (n 5 37, 11%), and cardiac disease (n 5 22, 7%). Ninety-nine patients required intubation. Intubations in the PED were performed by residents (20%), pediatric emergency medicine (PEM) fellows (15%), PEM attending staff (29%), and PICU fellows (12%); 81% of these were successful on the first attempt. In the PED, seven central lines were placed, seven intraosseous needles were inserted, 15 patients required inotropes, and 9 patients required chest compressions. Conclusion: Critical illness in our emergency department is a rare event; hence, opportunities to resuscitate, secure airways, and place central venous catheters are limited. Additional training, close working relationships between the PED and the PICU teams, and resuscitation protocols for early PICU involvement may be needed. RÉ SUMÉObjectif: Dé crire la fré quence des manoeuvres de ré animation et le taux de succè s dans un service des urgences pé diatriques (SUP). Ré sultats: Il y a eu 75 133 visites à l'urgence des soins pé diatriques; 304 des 329 visites (92,4 %) ré pondant aux critè res d'inclusion ont é té analysé es. Les diagnostics comprenaient : dé tresse respiratoire (n 5 115, 35 %), traumatismes (n 5 50, 15 %), sepsis (n 5 36, 11 %), convulsions (n 5 37, 11 %), et maladie cardiaque (n 5 22, 7 %). Quatre-vingt-dix-neuf patients ont né cessité une intubation. Les intubations au SUP ont é té ré alisé es par les ré sidents (20 %), les moniteurs cliniques (fellows) en mé decine d'urgence pé diatrique (15 %), les mé decins traitants du SUP (29 %), les moniteurs cliniques à l'USIP (12 %). Le taux de succè s de ces intubations à la premiè re tentative é tait de 81 %. Au SUP, 7 cathé ters centraux et 7 abords veineux intra-osseux ont é té mis en place, des inotropes ont é té administré s à 15 patients et des compressions thoraciques pratiqué es chez 9 patients. Conclusion: Des cas de maladies graves sont rares à notre service d'urgence. Les occasions de pratiquer des manoeuvres de ré animation, d'ouvrir les voies aé riennes et de poser un cathé ter central sont donc limité es. Il faut envisager une formation supplé mentaire, des relations de travail é troites entre les é quipes du SUP et de l'USIP et la mise en place de protocoles de ré animation pour une intervention pré coce de l'USIP.

show abstract

“…69 Use RSI only if you are trained, and have experience using these medications and are proficient in the evaluation and management of the pediatric airway. If you use RSI you must have a secondary plan to manage the airway in the event that you cannot achieve intubation.…”

Section: Ventilation With An Endotracheal Tubementioning

confidence: 99%