Comparison of Standard rapi̇d Sequential Intubation Protocol With Rocuronium in Emergency Department

Study Overview
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Brief Summary
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Airway management and advanced airway management are the issues that are applied every day in emergency services and that the emergency physician should know best. Rapid sequential intubation is one of the most frequently used techniques in advanced airway management. However, anesthetic agents and paralytic agents have some concerns with some side effects. In our study, This study aimed to compare the effect of standard rapid sequential intubation protocol and application of rocuronium priming technique on the procedure time and hemodynamic profile.

Detailed Description
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This study is a prospective, observational and randomized study conducted between 15.07.2021 and 01.12.2021 in Ankara City Hospital Emergency Medicine Clinic, which is a third-level emergency department with approximately 450,000 patient admissions per year. Patients who applied to the emergency department and needed rapid sequential intubation were included in our study. Randomization was done according to the order of arrival of the cases. The demographic characteristics of the patients included in the study and the presence of diabetes mellitus were recorded. Routine rapid sequential intubation was performed in the standard group. In the priming group, 10% of the rocuronium dose was administered approximately 3 minutes before the induction agent. Intubation time, amount of drug used, vital signs before and after intubation, and end tidal carbon dioxide level to confirm intubation were recorded.

Official Title
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Comparison of Standard rapi̇d Sequential Intubation Protocol With Rocuronium Priming Technique in Patients Registering to the Emergency Department and With Indication of Elective Intubation

Conditions
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Rapid Sequence Induction and Intubation, Rocuronium

Intervention / Treatment
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* Drug: priming with rocuronium


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be over the age of 18 Need for advanced airway To give consent or consent to participate in the study consent of relatives of those who are unable to give Exclusion Criteria: Have an indication of a crush (rescue) airway Have one of the difficult airway predictor Look, Evaluate, Obstruction, Neck mobility criteria maxillofacial anomaly or trauma detected during laryngoscopy with a cormack-lehane score of 3 and 4 patients Those who have inconveniences in applying ketamine to the clinic of the patient with a rocuronium or ketamine allergy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| standard<br>standard rapid sequence intubation group (paralysis following induction) | |
| priming<br>group primed with rocuronium before induction | Drug: priming with rocuronium<br>* Following induction (paralysis after onset of the induction effect) in routine rapid sequence intubation protocols While paralysis is applied, it is aimed to shorten the half-life of rocuronium by administering a subparalytic dose of rocuronium approximately 3-5 minutes before induction in the priming technique<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intubation time | when successful endotracheal intubation is performed after induction | ten minutes | 
| blood pressure systolic and diastolic | mmhg | ten minutes | 
| heart rate | beats/minute | ten minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| indirect perfusion | Indirect tissue perfusion interpretation with endtidal carbon dioxide levels | ten minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rocuronium, Rapid Sequence Induction and Intubation