Emergency Surgical Anesthesia: Rapid Sequence Induction, Hemorrhage Control and Perioperative Stabilization

Emergency surgical anesthesia in trauma and emergency room settings is essential, where rapid and efficient intervention is necessary to maximize patient outcomes. Three essential components of emergency surgical anesthesia are examined in this literature review: rapid sequence induction (RSI), hemorrhage control and perioperative stabilization. RSI is a fundamental technique for securing the airway in critically injured or ill patients, ensuring rapid unconsciousness and neuromuscular blockade while reducing the risk of aspiration. Common pharmacologic agents used include etomidate, ketamine, propofol, midazolam, fentanyl, and neuromuscular blockers, each with specific considerations and potential side effects. To lower mortality in trauma patients, hemorrhage control measures are crucial. Effective hemorrhage management in trauma care is advancing through innovative techniques such as viscoelastic testing, AI support, and novel hemostatic methods, including resuscitative endovascular balloon occlusion of the aorta, bioengineered clotting agents, and 3D-printed vascular grafts. To increase survival rates and avoid complications, perioperative stabilization, which includes fluid management, hemodynamic monitoring, and postoperative care, is essential. Oxygenation and ventilation strategies like protective lung ventilation, high-flow nasal cannula, and extracorporeal membrane oxygenation are essential in optimizing patient survival and extending critical care capabilities in resource-limited settings. This review highlights significant developments and challenges in trauma surgery by synthesizing current research and best practices in emergency anesthesia.