The association of ketamine induction with blood pressure changes in paramedic rapid sequence intubation of out‐of‐hospital traumatic brain injury

2021 ◽  
Author(s):  
Pieter F. Fouche ◽  
Ben Meadley ◽  
Toby St Clair ◽  
Alison Winnall ◽  
Paul A. Jennings ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence ◽  
Pressure Changes

Paramedic Rapid Sequence Intubation for Severe Traumatic Brain Injury: Perspectives from an Expert Panel

2007 ◽  
Vol 11 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Daniel P. Davis ◽  
Samir M. Fakhry ◽  
Henry E. Wang ◽  
Eileen M. Bulger ◽  
Robert M. Domeier ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Expert Panel ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

Efficacy of pre-hospital rapid sequence intubation in paediatric traumatic brain injury: A 9-year observational study

Injury ◽  
2018 ◽  
Vol 49 (5) ◽  
pp. 916-920 ◽  
Author(s):  
Stefan Heschl ◽  
Ben Meadley ◽  
Emily Andrew ◽  
Warwick Butt ◽  
Stephen Bernard ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Observational Study ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury

2003 ◽  
Vol 54 (3) ◽  
pp. 444-453 ◽  
Author(s):  
Daniel P. Davis ◽  
David B. Hoyt ◽  
Mel Ochs ◽  
Dale Fortlage ◽  
Troy Holbrook ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

Ventilation Patterns in Patients With Severe Traumatic Brain Injury Following Paramedic Rapid Sequence Intubation

2005 ◽  
Vol 2 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Daniel P. Davis ◽  
Robyn Heister ◽  
Jennifer C. Poste ◽  
David B. Hoyt ◽  
Mel Ochs ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Rapid Sequence Intubation ◽  
Rapid Sequence

Temporal changes in blood pressure following prehospital rapid sequence intubation

2021 ◽  
pp. emermed-2020-210887
Author(s):  
Pieter Francsois Fouche ◽  
Ben Meadley ◽  
Toby StClair ◽  
Alison Winnall ◽  
Christopher Stein ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Median Number ◽  
Rapid Sequence Intubation ◽  
Trauma Patients ◽  
Shock Index ◽  
Fractional Polynomial ◽  
Rapid Sequence ◽  
Transient Elevation ◽  
Pressure Changes

BackgroundRapid Sequence intubation (RSI) is an airway procedure that uses sedative and paralytic drugs to facilitate endotracheal intubation. It is known that RSI could impact blood pressure in the peri-intubation period. However, little is known about blood pressure changes in longer time frames. Therefore, this analysis aims to describe the changes in systolic blood pressure in a large cohort of paramedic-led RSI cases over the whole prehospital timespan.MethodsIntensive Care Paramedics in Victoria, Australia, are authorised to use RSI in medical or trauma patients with a Glasgow Coma Scale <10. This retrospective cohort study analysed data from patientcare records for patients aged 12 years and above that had received RSI, from 1 January 2008 to 31 December 2019. This study quantifies the systolic blood pressure changes using regression with fractional polynomial terms. The analysis is further stratified by high versus Low Shock Index (LSI). The shock index is calculated by dividing pulse rate by systolic blood pressure.ResultsDuring the study period RSI was used in 8613 patients. The median number of blood pressure measurements was 5 (IQR 3–8). Systolic blood pressure rose significantly by 3.4 mm Hg (p<0.001) and then returned to baseline in the first 5 min after intubation for LSI cases. No initial rise in blood pressure is apparent in High Shock Index (HSI) cases. Across the whole cohort, systolic blood pressure decreased by 7.1 mm Hg (95% CI 7.9 to 6.3 mm Hg; p<0.001) from the first to the last blood pressure measured.ConclusionsOur study shows that in RSI patients a small transient elevation in systolic blood pressure in the immediate postintubation period is found in LSI, but this elevation is not apparent in HSI. Blood pressure decreased over the prehospital phase in RSI patients with LSI, but increased for HSI cases.

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