Paramedic PapersHome Airway & ventilation Out-of-hospital RSI practice across South African services
Airway & ventilation
Out-of-hospital RSI practice across South African services
Out-of-hospital rapid sequence intubation practices by emergency care practitioners in selected provinces of South Africa: a retrospective cross-sectional review
BMC Emergency Medicine · 2026-11-09 · Added 12 November 2026
A South African multicentre record review of 354 out-of-hospital RSIs performed by emergency care practitioners across three provinces found trauma accounted for 67% of cases, ketamine was documented in 75% and rocuronium in 52%, with pre-oxygenation in 99% and capnography in 84% of cases.
- Study type
- Cross-sectional
- Design
- Multicentre retrospective cross-sectional record review
- Participants
- 354 RSI cases (from 535,479 patient care records screened)
- Main finding
- Trauma caused 238/354 (67.2%) of RSIs; ketamine documented in 74.9%, rocuronium in 52.3%, pre-oxygenation in 99.4%, end-tidal CO2 monitoring in 83.6% and post-intubation sedation/analgesia in 72%
- Caveat
- Retrospective documentation review — missing records may undercount care and adverse events
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). Drug-assisted intubation is an intensive care paramedic skill in most Australian services, and rocuronium is not carried by all of them — but the drug choices, monitoring standards and adverse-event questions are the same debates.
Learning goal
Strengthen my documentation of post-intubation sedation, analgesia and capnography to support safer out-of-hospital RSI.
More
- Topic: Airway & ventilation
- Daily scan: 12 November 2026
- Podcast: Paramedic Papers Daily, 12 November 2026
Related papers on Airway & ventilation
-
Intubation linked to more ROSC in OHCA registry
A Chinese regional EMS registry cohort of 6,162 adult non-traumatic out-of-hospital cardiac arrest patients found prehospital endotracheal intubation associated with more prehospital ROSC than basic airways (21.1% vs 3.8%, propensity-matched OR 6.33).
-
Ultrasound tube confirmation: thin evidence on the road
A scoping review of 51 studies on point-of-care ultrasound for confirming endotracheal tube placement in prehospital and critical care transport found only one primary study of diagnostic accuracy in actual out-of-hospital patients and none measuring patient-oriented outcomes.
-
Transport ventilation during CPR feasible in pilot
A Thai exploratory pilot compared transport mechanical ventilation (HAMILTON-T1, volume-controlled) with bag-valve ventilation during CPR in adult OHCA and found no significant differences in PCO2, pH, pO2, sustained ROSC or 28-day survival, with mechanical ventilation operationally feasible.
-
Real-time feedback tidies BVM ventilation in arrest
A Paris before-and-after study of 163 arrests found real-time feedback during bag-valve-mask ventilation improved insufflated-volume adherence (68% vs 42% of breaths in the 400–600 mL range) and cut leak volume by 12%, although expired tidal volumes were unchanged.