IMEMR
EMRO
Volume 7, Issue 2 (2026)
J Clinic Care Skill 2026, 7(2): 89-92 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2026/03/14 | Accepted: 2026/04/27 | Published: 2026/05/8
Received: 2026/03/14 | Accepted: 2026/04/27 | Published: 2026/05/8
How to cite this article
Roozbakhshian N, Hakiminia B, Firouzbakht B. Management of Rapid Sequence Induction During Emergency Laparotomy in a Trauma Center in Iran. J Clinic Care Skill 2026; 7 (2) :89-92
URL: http://jccs.yums.ac.ir/article-1-505-en.html
URL: http://jccs.yums.ac.ir/article-1-505-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rights and permissions
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
1- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
2- “Physiology Research Center, Neuroscience Research Institute” and “Department of Clinical Pharmacy, Faculty of Pharmacy”, Semnan University of Medical Sciences, Semnan, Iran
3- Department of Anesthesiology, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
2- “Physiology Research Center, Neuroscience Research Institute” and “Department of Clinical Pharmacy, Faculty of Pharmacy”, Semnan University of Medical Sciences, Semnan, Iran
3- Department of Anesthesiology, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract (593 Views)
Aims: This study aimed to evaluate the effectiveness and clinical outcomes of rapid sequence induction in a patient with abdominal trauma undergoing emergency laparotomy at an Iranian trauma center.
Patients & Methods: We reported the case of a 50-year-old man with abdominal trauma and internal hemorrhage who underwent emergency laparotomy following rapid sequence induction at a trauma center in Iran.
Findings: In the patient with severe hemorrhagic shock who underwent emergency laparotomy, rapid-sequence induction with ketamine (120mg), followed by succinylcholine (90mg), enabled successful endotracheal intubation without reported complications. Following blood transfusion, vasopressor support, fluid resuscitation, and surgical control of the bleeding, the patient’s hemodynamic status improved. He was subsequently transferred to the intensive care unit while intubated, with a blood pressure of 110/90mmHg, a heart rate of 80beats/min, and an oxygen saturation of 97%.
Conclusion: Ketamine-based rapid-sequence induction followed by succinylcholine provides effective airway control while helping preserve hemodynamic stability in critically ill patients at high risk of aspiration.
Patients & Methods: We reported the case of a 50-year-old man with abdominal trauma and internal hemorrhage who underwent emergency laparotomy following rapid sequence induction at a trauma center in Iran.
Findings: In the patient with severe hemorrhagic shock who underwent emergency laparotomy, rapid-sequence induction with ketamine (120mg), followed by succinylcholine (90mg), enabled successful endotracheal intubation without reported complications. Following blood transfusion, vasopressor support, fluid resuscitation, and surgical control of the bleeding, the patient’s hemodynamic status improved. He was subsequently transferred to the intensive care unit while intubated, with a blood pressure of 110/90mmHg, a heart rate of 80beats/min, and an oxygen saturation of 97%.
Conclusion: Ketamine-based rapid-sequence induction followed by succinylcholine provides effective airway control while helping preserve hemodynamic stability in critically ill patients at high risk of aspiration.
Keywords:
Emergency [MeSH], Laparotomy [MeSH], Rapid Sequence Induction [MeSH], Succinylcholine [MeSH], Ketamine [MeSH]
References
1. Ilyas C, Jones J, Fortey S. Management of the patient presenting for emergency laparotomy. BJA Educ. 2019;19(4):113-8. [Link] [DOI:10.1016/j.bjae.2018.12.002]
2. NELA Project Team. First patient report of the national emergency laparotomy audit. London: The Royal College of Anaesthetists; 2015. [Link]
3. Oumer KE, Ahmed SA, Tawuye HY, Ferede YA. Outcomes and associated factors among patients undergone emergency laparotomy: A retrospective study. Int J Surg Open. 2021;36:100413. [Link] [DOI:10.1016/j.ijso.2021.100413]
4. Holkunde R, Masur S, Patil BA, Patil C, Naik D, Lamani S. Comparison of different doses of atracurium for quality of muscle relaxation during modified rapid sequence induction in emergency laparotomy: A prospective randomised double blind study. Indian J Anaesth. 2022;66(12):849-53. [Link] [DOI:10.4103/ija.ija_285_22]
5. Collins J, O'Sullivan EP. Rapid sequence induction and intubation. BJA Educ. 2022;22(12):484-90. [Link] [DOI:10.1016/j.bjae.2022.09.001]
6. Klucka J, Kosinova M, Zacharowski K, De Hert S, Kratochvil M, Toukalkova M, et al. Rapid sequence induction: An international survey. Eur J Anaesthesiol. 2020;37(6):435-42. [Link] [DOI:10.1097/EJA.0000000000001194]
7. Avery P, Morton S, Raitt J, Lossius HM, Lockey D. Rapid sequence induction: Where did the consensus go?. Scand J Trauma Resusc Emerg Med. 2021;29(1):64. [Link] [DOI:10.1186/s13049-021-00883-5]
8. Costa B, Mourão J, Vale N. Personalized medicine for classical anesthesia drugs and cancer progression. J Pers Med. 2022;12(11):1846. [Link] [DOI:10.3390/jpm12111846]
9. Hager HH, Patel P, Burns B. Succinylcholine chloride. Treasure Island (FL): StatPearls Publishing; 2026. [Link]
10. Allene MD, Melekie TB, Ashagrie HE. Evidence based use of modified rapid sequence induction at a low income country: A systematic review. Int J Surg Open. 2020;25:17-23. [Link] [DOI:10.1016/j.ijso.2020.06.005]
11. Wahlen BM, El-Menyar A, Asim M, Al-Thani H. Rapid sequence induction (RSI) in trauma patients: Insights from healthcare providers. World J Emerg Med. 2019;10(1):19-26. [Link] [DOI:10.5847/wjem.j.1920-8642.2019.01.003]
12. Algie CM, Mahar RK, Tan HB, Wilson G, Mahar PD, Wasiak J. Effectiveness and risks of cricoid pressure during rapid sequence induction for endotracheal intubation. Cochrane Database Syst Rev. 2015;2015(11):Cd011656. [Link] [DOI:10.1002/14651858.CD011656.pub2]
13. Gropper MA, Cohen NH, Eriksson LI, Fleisher LA, Johnson-Akeju S, Leslie K. Miller's anesthesia. 10th ed. Amsterdam: Elsevier; 2025. [Link]
14. Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev. 2015;2015(10):Cd002788. [Link] [DOI:10.1002/14651858.CD002788.pub3]
15. Stewart JC, Bhananker S, Ramaiah R. Rapid-sequence intubation and cricoid pressure. Int J Crit Illn Inj Sci. 2014;4(1):42-9. [Link] [DOI:10.4103/2229-5151.128012]