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ketamine sequence intubation

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https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#1
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29405806/delayed-sequence-intubation-by-intensive-care-flight-paramedics-in-victoria-australia
#2
Jacinta Waack, Matthew Shepherd, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Delayed sequence intubation (DSI) involves the administration of ketamine to facilitate adequate preoxygenation in the agitated patient. DSI was introduced into the Clinical Practice Guideline for Intensive Care Flight Paramedics in Victoria in late 2013. We aimed to describe the clinical characteristics of patients receiving DSI. METHODS: A retrospective analysis was undertaken of patients who received DSI between January 1, 2014, and December 31, 2016, during both primary response and retrieval missions...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29276277/impact-of-developing-adult-ketamine-order-panels-for-the-emergency-department
#3
Haley Baird, Rachel Rumbarger
Background: Ketamine in adults has been identified as a safe and effective alternative for multiple indications, each with specific evidence-based dosing ranges. Emergency department (ED) providers are tasked with appropriate ordering of ketamine. A multi-institutional retrospective analysis within EDs at a large health system from November 2013 to October 2015 reviewed ED adult ketamine prescribing patterns for procedural sedation (PS), rapid sequence intubation (RSI), and analgesia. Retrospective cohort results revealed 56% (84 of 150) of PS, 64% (16 of 25) of RSI, and 81...
July 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28889210/ketamine-and-midazolam-differently-impact-post-intubation-hemodynamic-profile-when-used-as-induction-agents-during-emergency-airway-management-in-hemodynamically-stable-patients-with-st-elevation-myocardial-infarction
#4
Marco Zuin, Gianluca Rigatelli, Fabio Dell'Avvocata, Giuseppe Faggian, Luca Conte, Sara Giatti, Flavio Michielan, Loris Roncon
We investigated the incidence of post-intubation hypotension (PIH) in hemodynamically stable patients with STEMI requiring rapid sequences intubation (RSI) and medicated with ketamine or midazolam as induction agent. STEMI patients admitted between 1st January 2009 and 1st January 2017 who did not receive any type of inotropic support before the endotracheal intubation (ETI) was reviewed. PIH was defined as a reduction greater than 20% or a drop of systolic blood pressure (SBP) below 90 mmHg within 10 min from the administration of the induction agent [ketamine (1 mg/kg) or midazolam (0...
September 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28582801/emergency-airway-management-in-australian-and-new-zealand-emergency-departments-a-multicentre-descriptive-study-of-3710-emergency-intubations
#5
Hatem Alkhouri, John Vassiliadis, Matthew Murray, John Mackenzie, Alex Tzannes, Sally McCarthy, Toby Fogg
OBJECTIVE: The aim of this study was to describe the practice of endotracheal intubation across a range of Australasian EDs. METHODS: We established a multicentre airway registry (The Australian and New Zealand Emergency Department Airway Registry [ANZEDAR]) prospectively capturing intubations from 43 Australian and New Zealand EDs over 24 months using the ANZEDAR form. Information recorded included patient demographics, intubation indications, predicted difficulty, rapid sequence induction and endotracheal intubation preparation technique, induction drugs, airway adjuncts and complications...
October 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27993308/comparison-of-etomidate-and-ketamine-for-induction-during-rapid-sequence-intubation-of%C3%A2-adult-trauma-patients
#6
COMPARATIVE STUDY
Cameron P Upchurch, Carlos G Grijalva, Stephan Russ, Sean P Collins, Matthew W Semler, Todd W Rice, Dandan Liu, Jesse M Ehrenfeld, Kevin High, Tyler W Barrett, Candace D McNaughton, Wesley H Self
STUDY OBJECTIVE: Induction doses of etomidate during rapid sequence intubation cause transient adrenal dysfunction, but its clinical significance on trauma patients is uncertain. Ketamine has emerged as an alternative for rapid sequence intubation induction. Among adult trauma patients intubated in the emergency department, we compare clinical outcomes among those induced with etomidate and ketamine. METHODS: The study entailed a retrospective evaluation of a 4-year (January 2011 to December 2014) period spanning an institutional protocol switch from etomidate to ketamine as the standard induction agent for adult trauma patients undergoing rapid sequence intubation in the emergency department of an academic Level I trauma center...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27699989/prehospital-ketamine-use-by-paramedics-in-the-australian-capital-territory-a-12-month-retrospective-analysis
#7
Gregory J Hollis, Toby M Keene, Rory M Ardlie, David Ge Caldicott, Stuart G Stapleton
OBJECTIVE: The aim of this study was to describe prehospital use of ketamine by ACT Ambulance Service, and frequency of endotracheal intubation. METHODS: This was a retrospective study of patients receiving prehospital ketamine between 1 January and 31 December 2013. Episodes were identified from the prehospital electronic patient care records, then linkage to ED records at two receiving hospitals. Demographics, dose, indication and occasions of intubation were analysed...
February 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27693070/is-there-a-role-for-intravenous-subdissociative-dose-ketamine-administered-as-an-adjunct-to-opioids-or-as-a-single-agent-for-acute%C3%A2-pain-management-in-the-emergency-department
#8
REVIEW
Sergey Motov, Steven Rosenbaum, Gary M Vilke, Yuko Nakajima
BACKGROUND: Whether acute or chronic, emergency physicians frequently encounter patients reporting pain. It is the responsibility of the emergency physician to assess and evaluate, and if appropriate, safely and effectively reduce pain. Recently, analgesics other than opioids are being considered in an effort to provide safe alternatives for pain management in the emergency department (ED). Opioids have significant adverse effects such as respiratory depression, hypotension, and sedation, to say nothing of their potential for abuse...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27692755/apnea-after-low-dose-ketamine-sedation-during-attempted-delayed-sequence-intubation
#9
Brian E Driver, Robert F Reardon
Some patients are agitated and unable to tolerate conventional preoxygenation methods, including face mask oxygen or noninvasive positive-pressure ventilation. Sedation with ketamine for preoxygenation, also known as delayed sequence intubation, is a technique that can be used to achieve preoxygenation in this patient population. No complications of delayed sequence intubation have previously been reported. A 60-year-old woman presented with acute hypoxic respiratory failure. Despite application of high-flow oxygen (60 L/min) with a nonrebreather face mask, her oxygen saturation remained at 93%...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27646281/collective-review-of-the-status-of-rapid-sequence-intubation-drugs-of-choice-in-trauma-in-low-and-middle-income-settings-prehospital-emergency-department-and-operating-room-setting
#10
REVIEW
Leressè Pillay, Timothy Hardcastle
INTRODUCTION: Establishing a definitive airway in order to ensure adequate ventilation and oxygenation is an important aspect of resuscitation of the polytrauma patient . AIM: To review the relevant literature that compares the different drugs used for rapid sequence intubation (RSI) of trauma patients, specifically reviewing: premedication, induction agents and neuromuscular blocking agents across the prehospital, emergency department and operating room setting, and to present the best practices based on the reviewed evidence...
May 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27462175/effects-of-low-dose-ketamine-on-succinylcholine-induced-postoperative-myalgia-in-outpatient-surgeries-a-randomized-double-blind-study
#11
Karim Nasseri, Sanaz Arvien
OBJECTIVE: Despite the many complications of succinylcholine, it is still widely used as a superior muscle relaxant for rapid sequence induction. One of these complications is postoperative myalgia (POM). The aim of this study was to investigate the prophylactic effect of low-dose ketamine on the incidence and severity of POM. MATERIALS AND METHODS: In this double-blind clinical study, a total of 148 patients scheduled for general anesthesia were randomly divided into two equal groups...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27366551/influence-of-different-doses-of-ketamine-on-intubating-conditions-during-a-rapid-sequence-induction-and-intubation-model
#12
Başak Ceyda Meço, Ahmet Onat Bermede, Zekeriyya Alanoğlu, Olcay Yaka, Neslihan Alkış
OBJECTIVE: This prospective, randomized, double-blinded study aimed to compare the effects of three different doses of ketamine or lidocaine on intubating conditions and haemodynamics in a rapid-sequence induction model with 3 mg kg(-1) propofol and 0.6 mg kg(-1) rocuronium. METHODS: A total of 128 ASA I-III patients who were scheduled for elective surgery were randomized in the following five groups: Group 1 (n=24), 1 mg kg(-1) lidocaine+3 mg kg(-1) propofol+0...
February 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/26911672/delayed-sequence-intubation-is-it-ready-for-prime-time
#13
John A Taylor, Corinne Michele Hohl
Clinical question Does delayed sequence intubation (DSI) improve preoxygenation and safety when intubating otherwise uncooperative patients? Article chosen Weingart SD, Trueger S, Wong N, et al. Delayed sequence intubation: a prospective observational study. Ann Emerg Med 2015;65(4):349-55. doi:10.1016/j.annemergmed.2014.09.025 OBJECTIVE: To investigate whether the administration of ketamine 3 minutes prior to the administration of a muscle relaxant allows for optimal preoxygenation in uncooperative patients undergoing intubation...
January 2017: CJEM
https://www.readbyqxmd.com/read/26707248/delayed-sequence-intubation-with-ketamine-in-2-critically-ill-children
#14
Michael J Miescier, Robert J Bryant, Douglas S Nelson
No abstract text is available yet for this article.
June 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26416129/intubation-of-the-neurologically-injured-patient
#15
REVIEW
Joshua Bucher, Alex Koyfman
BACKGROUND: Intubation of the neurologically injured patient is a critical procedure that must be done in a manner to prevent further neurologic injury. Although many different medications and techniques have been used to meet specific needs, there is little to no evidence to support many claims. OBJECTIVE: To review the literature regarding important topics relating to intubating patients with neurologic injury. DISCUSSION: Airway management requires ideal preoxygenation and airway maneuvers to minimize manipulation of the larynx and to maximize first-pass success...
December 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26315876/the-effect-of-magnesium-sulphate-on-intubating-condition-for-rapid-sequence-intubation-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Mi-Hyun Kim, Ah-Young Oh, Sung-Hee Han, Jin-Hee Kim, Jung-Won Hwang, Young-Tae Jeon
STUDY OBJECTIVES: We compared magnesium sulphate with control, ketamine, rocuronium prime, and large-dose rocuronium (0.9 mg/kg) with regard to intubation conditions during rapid-sequence induction. DESIGN: This is a prospective, randomized, double-blinded study. SETTING: The setting is at an operating room in a university-affiliated hospital. PATIENTS: One hundred ten patients scheduled for general anesthesia were randomly allocated to the following 5 groups in equal numbers...
November 2015: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/26312006/complete-resistance-after-maximal-dose-of-rocuronium
#17
Annalisa Capuano, Maria Giuseppa Sullo, Concetta Rafaniello, Liberata Sportiello, Pierfrancesco Fusco, Macella De Vizia, Fausto Ferraro
Rocuronium is a non-depolarizing neuromuscular blocking agent (NDNMBA), employed in the clinic as an adjunct to general anesthesia to facilitate tracheal intubation rapid sequence, and to provide skeletal muscle relaxation during surgery. Many cases of resistance to neuromuscular blocking agents (NMBAs) have been anecdotally reported. There are specific pathologic states, such as upper motor neuron lesions, severe thermal injuries, liver disease, renal failure, disuse atrophy, all of which show an increased resistance to the effects of nondepolarizing muscle relaxants...
July 2015: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/25879683/significant-modification-of-traditional-rapid-sequence-induction-improves-safety-and-effectiveness-of-pre-hospital-trauma-anaesthesia
#18
COMPARATIVE STUDY
Richard M Lyon, Zane B Perkins, Debamoy Chatterjee, David J Lockey, Malcolm Q Russell
INTRODUCTION: Rapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and standardised RSI protocol may improve the safety and effectiveness of the procedure. A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to compare the safety and effectiveness of a traditional RSI protocol using etomidate and suxamethonium with a modified RSI protocol using fentanyl, ketamine and rocuronium...
April 1, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25747635/evolution-of-pararescue-medicine-during-operation-enduring-freedom
#19
REVIEW
Stephen Rush, Eric Boccio, Chetan U Kharod, Jason D'Amore
This article highlights recent advances made in U.S. Air Force Pararescue Medical Operations in relation to tactical evacuation procedures. Most of these changes have been adopted and adapted from civilian medicine practice, and some have come from shared experiences with partner nations. Patient assessment includes a more comprehensive evaluation for hemorrhage and indications for hemorrhagic control. Ketamine has replaced morphine and fentanyl as the primary sedative used during rapid sequence intubation and procedural sedation...
March 2015: Military Medicine
https://www.readbyqxmd.com/read/25689322/characteristics-of-patients-transported-by-a-paramedic-staffed-helicopter-emergency-medical-service-in-victoria-australia
#20
E Andrew, A de Wit, B Meadley, S Cox, S Bernard, K Smith
OBJECTIVE: The optimal staffing of helicopter emergency medical services (HEMS) is uncertain. An intensive care paramedic-staffed HEMS has operated in the state of Victoria, Australia for over 28 years, with paramedics capable of performing advanced procedures, including rapid sequence intubation, decompression of tension pneumothorax, and cricothyroidotomy. Administration of a wide range of vasoactive, anesthetic, and analgesic medications is also permitted. We sought to explore the characteristics of patients transported by HEMS in Victoria, and describe paramedic utilization of their skill set in the prehospital environment...
July 2015: Prehospital Emergency Care
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