Title: Post-intubation hypotension in trauma patients<br/>Author: Robert Flint<br/><a href='http://umem.org/profiles/faculty/2561/'>[Click to email author]</a><hr/><p> <span style="font-size:16px;"><span style="font-family:times new roman,times,serif;">Take away: Be prepared (with blood products and/or vasopressors) for hypotension in trauma patients post-intubation particularly the elderly and severely injured. Pre-intubation tachycardia predicts post-intubation hypotension. Resuscitation with saline in traumatically injured patients is inferior to blood products or permissive hypotension. </span></span></p> <p> </p> <p> <span style="font-size:16px;"><span style="font-family:times new roman,times,serif;">A UK study retrospectively looked at trauma patients undergoing helicopter based emergency medicine intubation using induction agents of fentanyl, ketamine, and rocuronium for hypotensive episodes. “This study demonstrates that more than one in five patients who undergo PHEA have a new episode of significant hypotension within the first ten minutes of induction. Increasing patient age, multi-system injuries, a higher baseline heart rate, and intravenous crystalloid administration by the ambulance service before HEMS arrival were all significantly associated with PIH, whereas the addition of fentanyl to the induction drug regime was not.”</span></span></p> <fieldset><legend>References</legend>
<p> <span style="color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">Price, J., Moncur, L., Lachowycz, K. </span><i style="margin: 0px; box-sizing: inherit; color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">et al.</i><span style="color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;"> Predictors of post-intubation hypotension in trauma patients following prehospital emergency anaesthesia: a multi-centre observational study. </span><i style="margin: 0px; box-sizing: inherit; color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">Scand J Trauma Resusc Emerg Med</i><span style="color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;"> </span><span style="margin: 0px; box-sizing: inherit; font-weight: bolder; color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">31</span><span style="color: rgb(51, 51, 51); font-family: -apple-system, "system-ui", "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">, 26 (2023). https://doi.org/10.1186/s13049-023-01091-z</span></p> </fieldset>