Clarification – "Pretreatment" in RSI

Letters

CJEM 2006;8(5):315

To the Editor: In the July issue of CJEM, Drs. Zed, Harrison and Kuzak1 expressed disappointment with our opinion2 that pre-treatment for rapid sequence intubation (RSI) is contraindicated. We would like to clarify that our correspondence regarding this practice in no way implied that pretreatment for RSI is contraindicated. The use of this term misrepresents material taught in our course. Our point is that, athough pretreatment may have benefit in certain circumstances, these remain poorly defined and the risk:benefit ratio of this therapy remains unproven. Pretreatment for RSI should not be allowed to complicate or delay timely airway management. Athough it is not "contraindicated," it should not be used as an indicator of "quality of care."

Sam Campbell, MB BCh
Department of Emergency Medicine
George Kovacs, MD, PHPE
Department of Emergency Medicine
Kirk MacQuarrie, MD
Department of Anesthesiology
And the AIME Instructors
Dalhousie University
Halifax, NS

References

1. Zed PJ, Harrison DW, Kuzak N. Pretreatment in rapid sequence intubation: Indicated or contraindicated? [letter]. Can J Emerg Med 2006;8(4):243-4.
2. Kovacs G, MacQuarrie K. Campbell S; and the AIME Instructors. Pretreatment in rapid sequence intubation: Indicated or contraindicated? [letter]. Can J Emerg Med 2006;8(4):243.