Prehospital Rapid Sequence Intubation in a Blunt Trauma Patient: A Case for High-Fidelity Simulation in Prehospital Medicine

Abstract

Abstract Introduction Rapid sequence intubation (RSI) is a procedure that has moved from the operating room to the emergency department and now to the prehospital setting. It is a procedure that has significant risk but is used infrequently, and therefore, providers have a tendency to lose proficiency. These facts make simulation training and evaluation of utmost importance. As our experience and skill as a specialty continue to improve, high-fidelity simulation scenarios can easily incorporate these techniques to improve patient outcomes. Methods This simulation case consists of four files that can be utilized by faculty implementing this evaluation/learning activity. This case can be presented with a single faculty member providing case information and role-playing various aspects of the case. It may be enhanced with additional actors or standardized patients. Results This scenario has been presented to 45 paramedics over 9 different days to evaluate their ability to maintain competence in RSI. Our experience to date has been that experienced paramedics are able to successfully negotiate this case without significant difficulty. As we have stressed the importance of the use of continuous waveform capnography and preprocedure resuscitation, the paramedics have been more successful in the management of these types of patients. Discussion This scenario provides an opportunity for paramedic evaluation and training in RSI. This high-fidelity simulation case format can be used for other high-risk, low-occurrence scenarios in prehospital care.

Keywords

• Simulation
• Emergency Medicine
• Rapid Sequence Intubation
• EMS
• Prehospital Medicine
• RSI