• Mark A Merlin, Huma Safdar, Susan Calabrese, Alex Lewinsky, Joseph Manfre, Stephen Van Pelt, and Andreia Marques-Baptista.
• University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, New Brunswick, New Jersey 08901, USA. merlinma@umdnj.edu
• Prehosp Disaster Med. 2010 Jul 1;25(4):341-5.

ObjectiveA rapid sequence intubation (RSI) method was introduced to a university-based emergency medical services (EMS) system. This is a report of the initial experience with the first 50 patients in a unique, two-tiered, two advanced life support (ALS) providers system.MethodsThe data were evaluated prospectively after an extensive RSI training period, consisting of didactic information and skills performance. Fifty consecutive patient records that documented the procedure were abstracted. Data abstracted included end-tidal CO2, heart rate, blood pressure, and pulse oximetry at various time intervals. Intubation success rates and number of attempts were documented. The consistency of proper documentation also was noted on patient care records.ResultsNo differences were noted in heart rate prior to RSI and one and five minutes after the RSI procedure was begun. No differences in blood pressure at one and five minutes were noted. Statistically significant improvements were found in pulse oximetry comparing prior to RSI and one minute after (p<0.001; 95% CI: 3.15-11.41) as well as prior to RSI and five minutes after RSI was started (p<0.0002; 95% CI=4.60-13.33). No differences were observed in end-tidal CO2 at one and five minutes. Overall intubation success rate was 96%, with 82% on first attempt and 92% on two or less attempts. Documentation for individual vitals was consistently <75%.ConclusionsPatients had no significant worsening of vital signs during the RSI procedure and mild improvement in pulse oximetry. Intubation success rates were consistent with national averages. Proper documentation was lacking in more than one quarter of the charts. These data add to a body of literature that raises further concerns regarding prehospital RSI.

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