Book Review: Rapid Sequence Intubation & Rapid Sequence Airway: An Airway 911 Guide



Keith Wesley, MD | | Thursday, November 12, 2009

By the authorÌs own admission, this isnÌt a comprehensive airway management text but is instead designed as an adjunct to a rapid sequence intubation (RSI) course. The text is written in a very relaxed, conversational tone and presents the fundamental elements of RSI and rapid sequence airway (RSA) management. RSA differs from RSI in that it deals with the placement of non-visualized airways, such as the Combitube and King airway, instead of the endotracheal tube.

The basic steps of RSI are clearly laid out with abundant illustrations, and case scenarios throughout the chapters provide excellent examples of particular points and should stimulate discussion. The sections on failed attempts are well written, and the author provides excellent suggestions for improving success on the next attempt.

The book perfectly describes the various devices and adjuncts used to perform intubation and improve first pass success; however, the Airway 911 course is based on the premise that a provider may have three failed attempts at intubation before going to a rescue airway device. This concept is very controversial, particularly in the prehospital arena. The text doesnÌt mention how to modify this for your service; therefore, anyone using this resource would be well served to read it thoroughly before adopting it outright.

I commend the author for his passion to provide prehospital providers with another resource for learning this high-acuity procedure, but I caution readers that Dr. Braude states several professional opinions that may be inconsistent with those of your medical director. Also, although icons within the chapters indicate associated texts are "evidenced based," they arenÌt specifically referenced to the bibliography.

The search for the pre-hospital airway management Holy Grail continues but Dr. Braude and other should be commended for their efforts. The bottom line is that no text stands alone without authoritative didactic interaction and skilled, hands-on practice.

Keith Wesley,MD, is the State EMS Medical Director for Minnesota and the medical director for Health East Medical Transportation in Minnesota.


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