ArticleCritical care (London, England)2015
Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04291521 (Prospective Study of Induction Medications Used in the Rapid Sequence Intubation of Trauma Patients and a Comparison of Effects on Outcomes), which is not on this map. Cited by 49 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Study of Induction Medications Used in the Rapid Sequence Intubation of Trauma Patients and a Comparison of Effects on Outcomes
Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Safer prehospital anaesthesia: updated guidelines from the Association of Anaesthetists.Anaesthesia · 2026Guideline
- Guideline
- Incidence of post-induction hypotension following emergency rapid sequence induction with ketamine: a systematic review and meta-analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- The impact of ketamine on emergency rapid sequence intubation: a systematic review and meta-analysis.BMC emergency medicine · 2024Pooled it
- Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The FAKT study-A randomized clinical trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Trial
- Randomized Trial of Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults.Critical care medicine · 2016Trial
- Maintenance of prehospital anaesthesia using an intermittent bolus regime in blunt trauma patients with a high GCS and hemodynamic reserve: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Airway management skills and devices on Italian helicopter emergency medical service: a national survey.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Emergency anaesthetic management in critically ill and injured patients: the STEPS approach (self, team, environment, patient and system).Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Prehospital Postintubation Hypotension and Survival in Severe Traumatic Brain Injury.JAMA network open · 2025Observational
- Comparison of Esketamine and Propofol for Prehospital Emergency Anaesthesia in Patients With Traumatic Brain Injury-A Retrospective Observational Study.Acta anaesthesiologica Scandinavica · 2025Observational
- Use of Muscle Relaxants in Emergency Medicine: A Review.Medical science monitor : international medical journal of experimental and clinical research · 2025Review
- Pre-hospital emergency anaesthesia in 2025: ten years on from the modification of induction regimes.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
- Maintenance of prehospital anaesthesia in trauma patients: inconsistencies and variability in practice.BJA open · 2025Article
- Association Between Fentanyl Use and Post-Intubation Mean Arterial Pressure During Rapid Sequence Intubation: Prospective Observational Study.The western journal of emergency medicine · 2025Observational
- The process of rapid sequence intubation in the prehospital setting: A scoping review.The Southern African journal of critical care : the official journal of the Critical Care Society · 2025Review
- Cardiorespiratory consequences of attenuated fentanyl and augmented rocuronium dosing during protocolised prehospital emergency anaesthesia at a regional air ambulance service: a retrospective study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Critical hypertension in trauma patients following prehospital emergency anaesthesia: a multi-centre retrospective observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
- Induction of pre-hospital emergency anaesthesia i-PHEA: a national survey of UK HEMS practice.BMC emergency medicine · 2023Article
- Ease of Intubation with McGrath Videolaryngoscope and Incidence of Adverse Events During Tracheal Intubation in COVID-19 Patients: A Prospective Observational Study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and standardised RSI protocol may improve the safety and effectiveness of the procedure. A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to compare the safety and effectiveness of a traditional RSI protocol using etomidate and suxamethonium with a modified RSI protocol using fentanyl, ketamine and rocuronium.
methodsWe performed a comparative cohort study of major trauma patients undergoing pre-hospital RSI by a physician-led Helicopter Emergency Medical Service. Group 1 underwent RSI using etomidate and suxamethonium and Group 2 underwent RSI using fentanyl, ketamine and rocuronium. Apart from the induction agents, the RSI protocol was identical in both groups. Outcomes measured included laryngoscopy view, intubation success, haemodynamic response to laryngoscopy and tracheal intubation, and mortality.
resultsCompared to Group 1 (n = 116), Group 2 RSI (n = 145) produced significantly better laryngoscopy views (p = 0.013) and resulted in significantly higher first-pass intubation success (95% versus 100%; p = 0.007). A hypertensive response to laryngoscopy and tracheal intubation was less frequent following Group 2 RSI (79% versus 37%; p < 0.0001). A hypotensive response was uncommon in both groups (1% versus 6%; p = 0.05). Only one patient in each group developed true hypotension (SBP < 90 mmHg) on induction.
conclusionsIn a comparative, cohort study, pre-hospital RSI using fentanyl, ketamine and rocuronium produced superior intubating conditions and a more favourable haemodynamic response to laryngoscopy and tracheal intubation. An RSI protocol using fixed ratios of these agents delivers effective pre-hospital trauma anaesthesia.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.