Beaumont Sur Oise

Researchers are evaluating an optimized strategy to reduce complications related to emergency tracheal intubation in adults experiencing vital distress. The study focuses on combining three interventions: using rocuronium as a paralytic agent to ease intubation, providing bag face-mask ventilation before intubation, and systematically using a Gum Elastic Bougie (GEB) to assist the first intubation attempt. This approach aims to lower the risks and morbidity associated with emergency intubations, especially in out-of-hospital settings. The study compares two approaches for rapid sequence intubation (RSI). One group receives rocuronium at 1.2 mg/kg with bag-mask ventilation between induction and laryngoscopy, and GEB is used systematically on the first attempt. The other group follows standard recommendations using succinylcholine at 1 mg/kg without systematic bag-mask ventilation, and GEB is only used if intubation fails under direct laryngoscopy. Emergency physicians will record immediate outcomes after out-of-hospital care and hospital data will be collected on day 28 after inclusion. Participants will undergo medical history review and physical examination including measurements of arterial pressure, oxygen saturation, and heart rate. The main outcome measured is the occurrence of severe complications related to intubation during the first hour after the procedure. Data collection includes out-of-hospital and intra-hospital monitoring, with follow-up to 28 days. This trial seeks to assess whether the combined strategy can improve safety and reduce intubation-related complications in emergency situations.