The value of intubating and paralyzing patients with suspected head injury in the emergency department

Jay A. Redan, David H. Livingston, Bartholomew J. Tortella, Benjamin F. Rush

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

One hundred consecutive trauma patients who underwent planned emergency intubation with muscle paralysis in the ED were studied to investigate the safety of these procedures and to determine their impact on the evaluation of patients with suspected head injury. Patients were intubated by either a surgeon (n = 47) or anesthesiologist (n = 53), and paralyzed with either vecuronium (n = 59) or succinylcholine (n = 41). Nasal intubation was used in 40 patients, oral in 57, and cricothyroidotomy in three. Ninety-four patients with suspected head injuries had a CT scan performed. Fifty-five (59%) had a positive scan and 15 required emergent neurosurgical intervention. Only two patients had lateral cervical spine roentgenograms before intubation; seven patients were eventually found to have cervical fractures. No patient suffered a neurologic deficit. One patient developed aspiration pneumonia following intubation. The three failed intubations occurred in patients with multiple facial fractures. We conclude that induced paralysis and intubation in the ED is safe, can facilitate the diagnostic workup, and may be a potentially life-saving maneuver in combative trauma patients.

Original languageEnglish (US)
Pages (from-to)371
Number of pages1
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume31
Issue number3
DOIs
StatePublished - Mar 1991

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

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