Rapid Sequence Induction and Intubation, Tracheal Intubation
Conditions
Brief summary
This clinical trial aims to understand the effect of the order of administration of Neuromuscular Blocking Agents (NMBAs) and sedatives on the success rate of intubation during Rapid Sequence Intubation (RSI) in the emergency department. The main questions to be answered include: 1. The impact of sequential drug administration order during rapid sequence induction (RSI) on first-pass intubation success rates. 2. Time to successful intubation 3. Hypoxia incidence (SpO₂ \<90%) 4. Risk of post-traumatic stress disorder (PTSD) 5. Procedure-related complications
Interventions
PROCEDUREDrug Sequence
Control: Sedative ( Propofol ) →within 30s→ NMBA ( Rocuronium ) → Intubation → 5min → Measure vital signs → After treatment → Remove tracheal intubation→ Recall of intubation Intervention: NMBA ( Rocuronium ) →within 30s→ Sedative(Propofol) → Intubation → 5min → Measure vital signs → After treatment → Remove tracheal intubation→ Recall of intubation
Sponsors
Zhongnan Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* in ED/EICU required emergency intubation * RSI required
Exclusion criteria
* Pregnancy * do not intubation orders * Declined participation * Other trials * Non-emergent cases * Active CPR
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First-pass success rate | Perioperative | Successful intubation on the first attempt, confirmed by any one of: Direct visualization of the ETT passing through vocal cords Bilateral breath sounds on auscultation Fiberoptic bronchoscopic confirmation of tracheal placement Sustained end-tidal CO₂ waveform (EtCO₂ \>15 mmHg for ≥3 breaths) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to intubation | Perioperative | from laryngoscopy start to confirmation (seconds) |
| Intubation recall | From drug injection to Remove the endotracheal tube | — |
| Changes in SBP | Perioperative | ΔSBP, :SBPₜ₀ - SBPₜ₁ ; (SBPₜ₀ - SBPₜ₁)/SBPₜ₀ × 100% |
| Changes in HR | Perioperative | ΔHR (absolute and percentage change):HRₜ₀ - HRₜ₁ ; (HRₜ₀ - HRₜ₁)/HRₜ₀ × 100% |
| Changes in SpO₂ | Perioperative | ΔSpO₂ (absolute and percentage change):SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ ; (SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ)/SpO₂ₜ₀ × 100% |
Countries
China
Outcome results
None listed