• Sattha Riyapan and Jeffrey Lubin.
• Department of Emergency Medicine, Penn State Hershey Medical Center, Hershey, PA; Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. Electronic address: sattha.riy@mahidol.ac.th.
• Air Med. J. 2016 Nov 1; 35 (6): 365-368.

ObjectiveThis study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI).MethodsWe performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%. We compared patients who received apneic oxygenation during RSI with patients who did not using the Fisher exact test.ResultsNinety-three patients were identified from the database; 29 (31.2%) received apneic oxygenation. Nineteen patients had an incidence of severe hypoxemia during RSI (20.43%; 95% confidence interval, 12.77%-30.05%). There was no statistically significant difference between the rate of severe hypoxemia between patients in the apneic oxygenation group versus the control group (17.2% vs. 21.9%, P = .78).ConclusionIn this study, patients who received apneic oxygenation did not show a statistically significant difference in severe hypoxemia during RSI.Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

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