An Observation Study of Rapid Sequence, Awake and Sedation-Only Intubations in an Emergency Department in Thai patients
Satariya Trakulsrichai MD*, Petchara Sundarathiti MD**, Phanorn Chalermdamrichai MD*, Isares Palasatien MD*, Sasivimol Rattanasiri PhD***, Porntip Chatchaipun MSc***, Sant Hathirat MD*
Affiliation : * Emergency Department, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand ** Anesthesiology Department, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand *** Section for Clinical Epidemiology and Biostatistics, Research Center, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
Background : Rapid Sequence Intubation (RSI) in emergency departments (EDs) is recognized as a corner-
stone of emergency airway management in developed countries. In Thailand, emergency medicine is a new
specialty and RSI is a novel method for patients in EDs. The observation of RSI and two former methods in EDs
were carried out to assess whether RSI was more successful and had lower immediate complication in Thai
patients or not.
Material and Method: The authors performed a retrospective study. The emergency airway management
records were reviewed and analyzed for the primary outcome. The primary outcome included the overall
success rate, the success rate within 1 attempt, the success rate within 2 attempts, and the overall immediate
complication rates for orotracheal intubations.
Results : Seventy-eight patients were included in the present study. The overall success rate, the success rate
within 1 attempt and the success rate within 2 attempts of the RSI group were statistically significantly higher
and the overall immediate complication rate of RSI group was statistically significantly lower than awake
and sedation-only intubation groups. No incidence of severe arrhythmia, cricothyroidotomy, and cardiac
arrest during the intubation were found.
Conclusion : RSI in EDs was more successful in selected patients compared to the two former methods in
emergency airway management in Thai patients. The clinical outcome especially that resulted from the
complication needs further study.
Keywords : Rapid Sequence Intubation (RSI), Emergency Department, The success rate
