Rapid Sequence Intubation (RSI)
in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method of intubation of injured and critically ill patients²

69%
RSI²

Transient O₂ desaturation during ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED: RSI occurs in
1 out of 3 patients⁵

Rectangle 54

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration
(when available)

•

Optimizing preoxygenation with EtO₂ Monitoring

EtO₂
is > 85%
EtO2

Guidelines suggest critically
ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

Evidence⁶ demonstrated that during RSI:

20%
Desaturation

20 % patients manifested desaturation SpO₂ <90 %

75%
Patients with
EtO₂<85%

Those patients did not reach EtO₂ >85 % at induction

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

1. Bag mask valve (BMV)
2. Airway adapter
3. HMEF filter
4. E-sCO module

gas-analyzer

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence
Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information.
Please visit www.gehealthcare.com. Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023

Rapid Sequence Intubation (RSI) in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method of intubation of injured and critically ill patients²

69%
RSI²

Transient O₂ desaturation during ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED: RSI occurs in 1 out of 3 patients⁵

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration
(when available)

•

Evidence⁶ demonstrated that during RSI:

20 % patients manifested desaturation SpO₂ <90 %

Those patients did not reach EtO₂ >85 % at induction

Optimizing preoxygenation with EtO₂ Monitoring

20%
Desaturation
75%
Patients with
EtO₂<85%
EtO₂
is > 85%
Rectangle 54 EtO2

Guidelines suggest critically
ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

1. Bag mask valve (BMV)
2. Airway adapter
3. HMEF filter
4. E-sCO module

gas-analyzer

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence
Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information.
Please visit www.gehealthcare.com. Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023

Rapid Sequence
Intubation (RSI) in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method
of intubation of injured
and critically ill patients²

69%
RSI²

Transient O₂
desaturation during
ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED:
RSI occurs in 1 out of 3 patients⁵

EtO2

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration
(when available)

•

Evidence⁶ demonstrated that during RSI:

20 % patients manifested desaturation SpO₂ <90 %

Those patients did not reach EtO₂ >85 % at induction

Optimizing preoxygenation with EtO₂ Monitoring

Rectangle 38
20%
Desaturation
75%
Patients with
EtO₂<85%

Guidelines suggest critically
ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

EtO₂
is > 85%

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

1. Bag mask valve (BMV)
2. Airway adapter
3. HMEF filter
4. E-sCO module

gas-analyzer

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence
Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information. Please visit www.gehealthcare.com.
Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023

Rapid Sequence
Intubation (RSI) in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method of intubation of injured and critically ill patients²

69%
RSI²

Transient O₂ desaturation during ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED:
RSI occurs in 1 out of 3 patients⁵

EtO2

Evidence⁶ demonstrated that during RSI:

Optimizing preoxygenation with EtO₂ Monitoring

20 % patients manifested desaturation SpO₂ <90 %

20%
Desaturation

Those patients did not reach EtO₂ >85 % at induction

75%
Patients with
EtO₂<85%

Guidelines suggest critically
ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

EtO₂
is > 85%
Rectangle 38

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration (when available)

•

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

1. Bag mask valve (BMV)
2. Airway adapter
3. HMEF filter
4. E-sCO module

gas-analyzer

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence
Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information. Please visit www.gehealthcare.com.
Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023

Rapid Sequence
Intubation (RSI) in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method of intubation of injured and critically ill patients²

69%
RSI²

Transient O₂ desaturation during ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED:
RSI occurs in 1 out of
3 patients⁵

Optimizing preoxygenation with EtO₂ Monitoring

Rectangle 55

Guidelines suggest critically ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

EtO₂
is > 85%

Evidence⁶ demonstrated that during RSI:

20%
Desaturation
75%
Patients with
EtO₂<85%

20 % patients manifested desaturation
SpO₂ <90 %

Those patients did not reach EtO₂ >85 % at induction

Rectangle 38

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration (when available)

•

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

1. Bag mask valve (BMV)
2. Airway adapter

gas-analyzer

3. HMEF filter
4. E-sCO module

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information. Please visit www.gehealthcare.com.
Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023

Rapid Sequence
Intubation (RSI) in the ED

The importance of EtO₂ monitoring to support patient preoxygenation

RSI evidence shows significantly high rate of adverse outcomes in ICU and ED compared with anesthetic practice¹

Most common method of intubation of injured and critically ill patients²

69%
RSI²

Transient O₂ desaturation during ED RSI3,4

Dysrhythmia
•
Hemodynamic decompensation
•
Hypoxic brain injury
•
Cardiac arrest
•
19.2%
Hypoxemia
3.4%
Dysrhythmia

Desaturation in ED: RSI occurs in 1 out of
3 patients⁵

The NAP4 guidelines suggested standard monitoring for ED, ICU, WARD¹

ECG
•
Oximetry
•
Heart rate
•
Blood pressure
•
Waveform capnography
•

End-tidal oxygen concentration
(when available)

•
Rectangle 38

Optimizing preoxygenation with EtO₂ Monitoring

Rectangle 56

Guidelines suggest critically ill patients undergoing

RSI to be preoxygenated
until EtO₂ is >85%¹

EtO₂
is > 85%

Evidence⁶ demonstrated that during RSI:

20%
Desaturation

20 % patients manifested desaturation
SpO₂ <90 %

75%
Patients with
EtO₂<85%

Those patients
did not reach
EtO₂ >85 % at induction

The use of a gas analyzer to measure FiO₂ and EtO₂ can provide a reliable measure of patient oxygenation during RSI⁷

gas-analyzer

1. Bag mask valve
     (BMV)
2. Airway adapter

3. HMEF filter
4. E-sCO module

Higgs, A., et al., Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth, 2018. 120(2): p. 323-352.

1.

Walls, R., et al., Emergency airway management: A multi-center report of 8937 emergency Department Intubations. J Emerg Med, 2011. 41(4): p. 347-354.

2.

Pourmand, A., et al., Pre-oxygenation: Implications in emergency airway management. Am J Emerg Med, 2017. 35(8): p. 1177-1183.

3.

Reid, C., et al., The who where, and what of rapid sequence intubation: Prospective observational study of emergency RSI outside the operating theatre. Emerg Med J, 2004. 21:296-301.

4.

Bodily, J.D., et al., Incidence and duration of Continuously Measured Oxygen Desaturation During emergency department intubation. Ann Emerg Med, 2016. 67(3): 389-395.

5.

Caputo, N.D., et al., Use of End Tidal Oxygen Monitoring to Assess Preoxygenation During Rapid Sequence Intubation in the Emergency Department. Ann Emerg Med, 2019. 74(3): p. 410-415.

6.

Murphy, S., et al., Novel Use of a Gas Analyzer Can Reliably Predict the Arterial Oxygen among Emergency Department Patients Undergoing Rapid Sequence Intubation. The Journal of Emergency Medicine, 2020.

7.

Not all products or features are available in all markets. Full product technical specification is available upon request. Contact a GE HealthCare Representative for more information. Please visit www.gehealthcare.com.
Data subject to change.
© 2023 GE HealthCare
GE is a trademark of General Electric Company used under trademark license. All other trademarks are property of their respective owners.
Reproduction in any form is forbidden without prior written permission from GE HealthCare. Nothing in this material should be used to diagnose or treat any disease or condition. Readers must consult a healthcare professional.

JB11222XX  12/2023