Developing a Rapid Sequence Intubation Course for an Advanced Life Support Ambulance Service

People can not survive without an intact and functional airway. Thus, the concept of airway is vital to survival. Paramedics of advanced life support ambulance services use airway management tools such as bag valve mask, oral and nasal pharyngeal airways, combitubes, nasal and oral tracheal intubation. While these tools are beneficial for airway breathing management, in some cases they are ineffective due to the severity of the illness or injury. Neuromuscular blocking drugs and intravenous (IV) anesthetics are routinely used for intubation for difficult airway management in hospital emergency rooms, intensive care units, and operating rooms. This technique is referred to as rapid sequence intubation (RSI). RSI enhances the ability of the care provider to effectively control the necessary airway and breathing needed for the patient to survive. A majority of paramedics of advanced life support ambulance services are currently not trained in RSI and have no alternative options when faced with a difficult airway that can not effectively be controlled with the current airway skills and tools available to them. This project has brought RSI beyond the hospital doors to the prehospital arena for paramedics of an advanced life support ambulance service. A protocol for the use of RSI and the training necessary to implement RSI has been developed for paramedics of an advanced life support ambulance service. Eighteen paramedics attended the airway course. The evaluation and feedback from the participants was positive indicating that the project was successful. RSI has now become another option for this advanced life support ambulance service to manage patients with difficult airways in the prehospital environment