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EMJ Online First, published on January 28, 2014 as 10.1136/emermed-2013-202930 Original article
Paramedic rapid sequence intubation in patients with non-traumatic coma S A Bernard,1,2,3 K Smith,1,2 R Porter,3 C Jones,1 A Gailey,1 B Cresswell,1 D Cudini,1 S Hill,1 B Moore,1 T St Clair1 1
Ambulance Victoria, Doncaster, Victoria, Australia Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3 The Intensive Care Unit, The Alfred Hospital, Melbourne, Victoria, Australia 2
Correspondence to Professor Stephen Bernard, The Intensive Care Unit, The Alfred Hospital, Commercial Rd, Melbourne, VIC 3004, Australia;
[email protected] Received 17 June 2013 Revised 25 November 2013 Accepted 1 January 2014
ABSTRACT Introduction Pre-hospital intubation by paramedics is widely used in comatose patients prior to transportation to hospital, but the optimal technique for intubation is uncertain. One approach is paramedic rapid sequence intubation (RSI), which may improve outcomes in adult patients with traumatic brain injury. However, many patients present to emergency medical services with coma of non-traumatic cause and the role of paramedic RSI in these patients remains uncertain. Methods The electronic Victorian Ambulance Clinical Information System was searched for the term ‘suxamethonium’ between 2008 and 2011. We reviewed the patient care records and included patients with suspected non-traumatic coma who were treated and transported by road-based paramedics. Demographics, intubation conditions, vital signs (before and after drug administration) and complications were recorded. Younger patients (
