This study compares two different methods of helping patients breathe by placing a tube in their airway (intubation) in an emergency setting. These methods are called Rapid Sequence Intubation (RSI) and Delayed Sequence Intubation (DSI). The study focuses on adult patients who are still breathing on their own but need a breathing tube for medical reasons not related to an injury (non-trauma). The main goal of the research is to compare: * Oxygen levels before and after the procedure. * The patient's vital signs (such as heart rate and blood pressure). * The number of attempts needed to successfully place the tube and the time the procedure takes. * Blood gas results and any complications that occur during or shortly after the procedure. * Early survival (mortality) rates. While there are previous studies on trauma patients or small observational reports, there is currently no large-scale, multicenter randomized controlled trial that includes all non-trauma adult patients. What makes this study unique? Confirmation of Tube Placement: Researchers will use a specific measurement called end-tidal CO2 (etCO2) to confirm the tube is in the right place, a method not used in similar previous studies. Assessing Difficulty: This study will use the Cormack-Lehane classification system to measure how difficult the intubation was for each patient. Standardization: For the first time, breathing machine (ventilator) settings will be standardized for all patients in this type of study. Real-World Practice: By involving all emergency department physicians as practitioners, the study aims to show how these methods work across a wide range of medical teams.
Age range
18 Years
Sex
ALL
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Number of Participants with Procedure-Related Adverse Events
Timeframe: During and 1 hours after intubation
Mean Peripheral Oxygen Saturation (SpO2)
Timeframe: Hospital admission, Intubation decision, Protocol start (0 min), Minutes 1, 2, 3 of protocol, During blade insertion, 1 minute post-intubation, and 5 minutes post-intubation
Mean Arterial Blood pH Levels
Timeframe: Hospital admission, At the time of intubation decision, and 15 minutes post-intubation.
Mean Partial Pressure of Carbon Dioxide (PaCO2)
Timeframe: Hospital admission, At the time of intubation decision, and 15 minutes post-intubation.
Mean Arterial Bicarbonate (HCO3) Concentration
Timeframe: Hospital admission, At the time of intubation decision, and 15 minutes post-intubation.
Mean Base Excess (BE) Levels
Timeframe: Hospital admission, At the time of intubation decision, and 15 minutes post-intubation.
Utku Murat Kalafat, Associate Professor
Mean Arterial Lactate Concentration
Timeframe: Hospital admission, At the time of intubation decision, and 15 minutes post-intubation.
First Hour Mortality
Timeframe: 1 hour later intubation
28th day mortality
Timeframe: 28 days after intubation