Tips to improve success rate of intubation

A standardized rapid sequence intubation protocol attached to the resuscitation cart

Research output: Contribution to journalArticle

Abstract

Objectives: The purpose of this study was to determine whether the implementation of a standardized rapid sequence intubation (RSI) protocol easily accessed on the resuscitation cart increased the success rate of intubation and reduced intubation-related complications in the emergency department (ED). Methods: This work was a retrospective study of patients who were intubated in the ED between February 2006 and June 2007. The RSI protocol and a dosage cross-table were attached to the resuscitation cart beginning in January 2007. Intubated patients before and after application of the protocol were sorted into two groups: pre-intervention and post-intervention. Results: A total of 147 patients were enrolled in the study, including 72 patients in the pre-intervention group and 75 patients in the post-intervention group. After application of the standardized protocol prompted on the resuscitation cart. The adherence rates to pre-treatment agents (69% vs. 90%; p < 0.01) and neuromuscular blocking agents (NMBA) (72% vs. 90%; p < 0.01) significantly improved. The first-attempt success rate was 57 of 72 (79%) in the pre-intervention group versus 70 of 75 (93%) in the post-intervention group (p = 0.016). The time to intubation did not differ signifi cantly, but the preintervention group had a higher percentage of prolonged time to intubation (13% vs. 3%; p = 0.029). The implementation of a standardized RSI protocol did not induce signifi cant adverse effects. Conclusions: Our study demonstrated implementation of a standardized RSI protocol, improved clinician adherence to the RSI, increased success of fi rst-attempt ED intubation and led to a decline in the rate of prolonged time to intubation.

Original languageEnglish
Pages (from-to)67-74
Number of pages8
JournalJournal of Acute Medicine
Volume7
Issue number2
DOIs
Publication statusPublished - 2017 Jun 1

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Intubation
Resuscitation
Hospital Emergency Service
Neuromuscular Blocking Agents
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

@article{c117ca4453414f6092e9dc9ab206a7e6,
title = "Tips to improve success rate of intubation: A standardized rapid sequence intubation protocol attached to the resuscitation cart",
abstract = "Objectives: The purpose of this study was to determine whether the implementation of a standardized rapid sequence intubation (RSI) protocol easily accessed on the resuscitation cart increased the success rate of intubation and reduced intubation-related complications in the emergency department (ED). Methods: This work was a retrospective study of patients who were intubated in the ED between February 2006 and June 2007. The RSI protocol and a dosage cross-table were attached to the resuscitation cart beginning in January 2007. Intubated patients before and after application of the protocol were sorted into two groups: pre-intervention and post-intervention. Results: A total of 147 patients were enrolled in the study, including 72 patients in the pre-intervention group and 75 patients in the post-intervention group. After application of the standardized protocol prompted on the resuscitation cart. The adherence rates to pre-treatment agents (69{\%} vs. 90{\%}; p < 0.01) and neuromuscular blocking agents (NMBA) (72{\%} vs. 90{\%}; p < 0.01) significantly improved. The first-attempt success rate was 57 of 72 (79{\%}) in the pre-intervention group versus 70 of 75 (93{\%}) in the post-intervention group (p = 0.016). The time to intubation did not differ signifi cantly, but the preintervention group had a higher percentage of prolonged time to intubation (13{\%} vs. 3{\%}; p = 0.029). The implementation of a standardized RSI protocol did not induce signifi cant adverse effects. Conclusions: Our study demonstrated implementation of a standardized RSI protocol, improved clinician adherence to the RSI, increased success of fi rst-attempt ED intubation and led to a decline in the rate of prolonged time to intubation.",
author = "Shih-Hao Lin and Chih-Hsien Chi and Chia-Chang Chuang and Tsung-Yu Chan",
year = "2017",
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AU - Lin, Shih-Hao

AU - Chi, Chih-Hsien

AU - Chuang, Chia-Chang

AU - Chan, Tsung-Yu

PY - 2017/6/1

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N2 - Objectives: The purpose of this study was to determine whether the implementation of a standardized rapid sequence intubation (RSI) protocol easily accessed on the resuscitation cart increased the success rate of intubation and reduced intubation-related complications in the emergency department (ED). Methods: This work was a retrospective study of patients who were intubated in the ED between February 2006 and June 2007. The RSI protocol and a dosage cross-table were attached to the resuscitation cart beginning in January 2007. Intubated patients before and after application of the protocol were sorted into two groups: pre-intervention and post-intervention. Results: A total of 147 patients were enrolled in the study, including 72 patients in the pre-intervention group and 75 patients in the post-intervention group. After application of the standardized protocol prompted on the resuscitation cart. The adherence rates to pre-treatment agents (69% vs. 90%; p < 0.01) and neuromuscular blocking agents (NMBA) (72% vs. 90%; p < 0.01) significantly improved. The first-attempt success rate was 57 of 72 (79%) in the pre-intervention group versus 70 of 75 (93%) in the post-intervention group (p = 0.016). The time to intubation did not differ signifi cantly, but the preintervention group had a higher percentage of prolonged time to intubation (13% vs. 3%; p = 0.029). The implementation of a standardized RSI protocol did not induce signifi cant adverse effects. Conclusions: Our study demonstrated implementation of a standardized RSI protocol, improved clinician adherence to the RSI, increased success of fi rst-attempt ED intubation and led to a decline in the rate of prolonged time to intubation.

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