Sequential Order of RSI on Tracheal Intubation

Zhongnan Hospital380 enrolled

Overview

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

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

380

Conditions

Tracheal Intubation Rapid Sequence Induction and Intubation

Interventions

Drug SequencePROCEDURE

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

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Locations (1)

Zhongnan Hospital of Wuhan University

Wuhan, China

Outcomes

Primary Outcomes

First-pass success rate

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)

Time frame: Perioperative

Secondary Outcomes

Time to intubation

from laryngoscopy start to confirmation (seconds)

Time frame: Perioperative

Intubation recall

Time frame: From drug injection to Remove the endotracheal tube

Changes in SBP

ΔSBP, :SBPₜ₀ - SBPₜ₁ ; (SBPₜ₀ - SBPₜ₁)/SBPₜ₀ × 100%

Time frame: Perioperative

Changes in HR

ΔHR (absolute and percentage change):HRₜ₀ - HRₜ₁ ; (HRₜ₀ - HRₜ₁)/HRₜ₀ × 100%

Time frame: Perioperative

Changes in SpO₂

ΔSpO₂ (absolute and percentage change):SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ ; (SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ)/SpO₂ₜ₀ × 100%

Time frame: Perioperative

Data from ClinicalTrials.gov

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