Preoxygenation reduces desaturation events and improves intubation success

Air Medical Journal
Daniel P DavisSteve A Aguilar

Abstract

Oxygen desaturation occurs frequently in the course of prehospital rapid sequence intubation (RSI) and is associated with increased morbidity and mortality. Preoxygenation with positive pressure ventilation by bag valve mask may delay the onset of desaturation. The purpose of this study was to evaluate implementation of a targeted preoxygenation protocol including the use of positive pressure ventilation on desaturation events and intubation success during air medical RSI. The RSI air medical program airway training model was modified to target an oxygen saturation as measured by pulse oximetry value of ≥ 93% before initial laryngoscopy. A review of oxygen saturation as measured by pulse oximetry tracings was performed for 2 years before and 2 years after implementation of this protocol. The incidence of desaturation events and overall intubation success rates were compared before and after the intervention. One hundred fifty-five RSI procedures were evaluated over the study period. Desaturation events decreased from 58% in the 2 years before algorithm changes to 28% in the first year and 14% in the second year after implementation (P < .01). Intubation success rates increased from 89% to 98% (P < .01). There were no self-repor...Continue Reading

References

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Mar 15, 2006·Current Opinion in Anaesthesiology·Christian C Apfel, Norbert Roewer
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Sep 23, 2010·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Daniel P DavisMichelle Jennings

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Citations

May 26, 2016·British Journal of Anaesthesia·B S NattJ M Mosier
Aug 10, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·John C Sakles
Apr 27, 2017·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Helmut TrimmelWolfgang G Voelckel
Oct 17, 2020·Anesthesia and Analgesia·Rebecca L KornasUNKNOWN Society for Airway Management’s Special Projects Committee

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