Success rate of RSI

Q: With proper planning and preparation, the success rate of rapid sequence intubation is almost 99%.

A) True

B) False

Answer: A

The major reason for failed intubation, defined as "can't intubate, can't oxygenate," is mostly due to poor pre-procedure preparation under stressful conditions outside the OR, where unfortunately highly trained anesthesia staff is not always present. 

Said that when proper planning is done, full backup support is obtained, maximum pre-oxygenation is done, and the Neuro-Muscular Blockade (NMB) is properly administrated - the success rate is 99.6 percent with succinylcholine and 99.9 percent with rocuronium. 

This conclusion came from the famous National Emergency Airway Registry (NEAR) and two large multi-center data comprising almost 15,000 intubations.

#procedures

References:

1.April MD, Arana A, Pallin DJ, et al. Emergency Department Intubation Success With Succinylcholine Versus Rocuronium: A National Emergency Airway Registry Study. Ann Emerg Med 2018; 72:645.

2. Sagarin MJ, Barton ED, Chng YM, et al. Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts. Ann Emerg Med 2005; 46:328.

3. Walls RM, Brown CA 3rd, Bair AE, et al. Emergency airway management: a multi-center report of 8937 emergency department intubations. J Emerg Med 2011; 41:347.