Use Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department

Apneic oxygenation — the provision of high-flow nasal cannula oxygen to patients during, not just before, rapid sequence intubation (RSI) in order to delay the onset of hypoxemia — has been cited as a best practice. However, there have been few studies of its utility in the emergency setting. In an observational study at an emergency department that introduced the practice, investigators compared rates of first-pass success without hypoxemia between patients who were and were not provided apneic oxygenation during RSI by resident trainees.

During the two-year study period, 380 received apneic oxygenation and 255 did not. Most patients (76%) were intubated for anticipated clinical course and need for proximate intubation, and few (17%) were i…