The incidence of oxygen desaturation during rapid sequence induction and intubation
Open accessAbstract
BACKGROUND: Rapid sequence induction and intubation (RSII) is an emergency airway management technique for patients with a risk of pulmonary aspiration. It involves preoxygenation, administration of predetermined doses of induction and paralytic drugs, avoidance of mask ventilation, and laryngoscopy followed by tracheal intubation and keeping cricoid pressure applied till endotracheal tube cuff be inflated. Oxygen desaturation has been seen during RSII. We assessed the incidence of oxygen desaturation during RSII. METHODS: An institution-based observational study was conducted from March 3 to May 4, 2014 in our hospital. All patients who were operated upon under general anesthesia with RSII during the study period were included. A checklist was prepared for data collection. RESULTS: A total of 153 patients were included in this study with a response rate of 91.6%. Appropriate drugs for RSII, equipments for RSII, equipments for difficult intubation, suction machine with a catheter, a monitor and an oxygen backup such as ambu bag were not prepared for 41 (26.8%), 50 (32.7%), 51 (33.3%), 38 (24.8%) and 25 (16.3%) patients respectively. Cricoid pressure was not applied at all for 17 (11.1%) patients and 53 (34.6%) patients were ventilated after induction of anesthesia but before intubation and endotracheal cuff inflation. A total of 55 (35.9%) patients desaturated during RSII (SPO2<95%). The minimum, maximum and mean oxygen desaturations were 26%, 94% and 70.9% respectively. The oxygen desaturation was in the range of <50%, 50%-64%, 65%-74%, 75%-84%, 85%-89 % and 90%-94% for 6 (3.9%), 7 (4.6%), 5 (3.3%), 10 (6.5%), 13 (8.5%) and 14 (9.2%) patients respectively. CONCLUSION: The incidence of oxygen desaturation during RSII was high in our hospital. Preoperative patient optimization and training about the techniques of RSII should be emphasized.
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The incidence of peri-intubation desaturation, hypocapnea, and hypotension in emergency intubations is relatively high.
“Given the relatively high incidence of peri-intubation desaturation, hypocapnea, and hypotension in emergency intubations”
From Airway Management in Trauma (2018) · cites this paper as [25]
The Discussion reports a high oxygen-desaturation incidence during rapid sequence induction and intubation (55/153, 35.9%), and the techniques section reports hypotension in 23 patients (15%). The study involved patients undergoing operations under general anesthesia with rapid sequence induction, rather than emergency intubations generally. Our copy does not report an incidence of hypocapnea. (LLM, conf=0.89)
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Kovacs, G., & Sowers, N. (2018) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2017.08.006 · Cited by 115 · see citing works
- Authors
- Gebremedhn, E. G., Mesele, D., Aemero, D., & Alemu, E.
- Affiliations
- University of Gondar (ET)
- Venue
- World Journal of Emergency Medicine
- Publisher
- World Journal of Emergency Medicine
- Published
- 2014
- Volume
- 5
- Issue
- 4
- Pages
- 279
- ISSN
- 1920-8642 (ISSN-L)
- PMC
- PMC4272932
- OpenAlex
- W2070544369
- Cited by
- 23
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 4
- FWCI
- 4.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Journal of Emergency Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Gondar
- College of Medicine and Health Sciences, University of Gondar
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- rapid sequence induction, endotracheal intubation, oxygen desaturation, emergency airway management, preoxygenation, cricoid pressure, difficult intubation, general anesthesia, incidence, preoperative preparation
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