Effectiveness of Rapid Sequence Intubation Versus Non-Rapid Sequence Intubation In Traumatic Brain Injury Patients In Emergency Department

Syed Muhammad Hassan Kazmi; Muhammad Moaz Tamur Sarwar; Asma Bibi; Syeda Zainab; Zia Ul Haq; Muhammad Azeem

doi:10.51253/pafmj.v76iSUPPL-6.10125

Authors

Syed Muhammad Hassan Kazmi Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Moaz Tamur Sarwar Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Asma Bibi Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syeda Zainab Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Zia Ul Haq Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Azeem Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.10125

Keywords:

Intubation, non-RSI, RSI, traumatic brain injury (TBI).

Abstract

Objective: To compare the success of intubation and complications associated with performing rapid sequence intubation (RSI) versus non-rapid sequence intubation (NRSI) in patients with traumatic brain injury (TBI) presenting in the emergency department of a tertiary care hospital.

Study Design: Quasi experimental study

Place and Duration of Study: Department of Accident and emergency, Pak-Emirates Military Hospital Rawalpindi, Pakistan from May-Dec 2022

Methodology: The RSI group was intubated as per international RSI protocol with Injection Midazolam 0.1 mg/kg as the sedative agent and Injection Suxamethonium 2 mg/kg as the paralytic agent. Standard Macintosh blade of appropriate size according to patient parameters was used for intubating the trachea. Intubation done by the non-RSI method included intubation by Injection Midazolam 0.1 mg/kg alone without the use of any paralytic agent.

Results: When analyzing the primary outcomes of intubation success between both groups and number of attempts to achieve success, results showed success of intubation at first attempt in 89(84.8%) and on second attempt in 09 (8.6%) patients in the RSI group with an overall success rate in 98(93.3%) and intubation failure in 07(6.7%) patients (p<0.001). In comparison success of intubation in the non-RSI group revealed success at first attempt in 85(81%) patients with 07(6.7%) patients intubated in the second attempt with overall success in 92(87.6%) and failure in 13(12.4%) of the patients (p<0.001).

Conclusion: We conclude that rapid sequence intubation be considered as first-line intubation method for TBI when no contraindication for paralytic agent is present.

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