REBEL Cast REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients
Aug 7, 2023
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DSI vs. RSI
- Traditional RSI involves pre-oxygenation, induction, and neuromuscular blockade.
- DSI dissociates with ketamine, allowing pre-oxygenation before paralysis and intubation.
Study Focus
- This study compares delayed sequence intubation (DSI) to rapid sequence intubation (RSI).
- It assesses peri-intubation hypoxia in trauma patients needing airway control.
Key Results
- DSI showed significantly less peri-intubation hypoxia (8%) than RSI (35%).
- DSI also had a higher first-attempt success rate (83% vs. 69%).
Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation. The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge. Traditional RSI entails preoxygenation followed by ...