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In anaesthesia and advanced airway management, rapid sequence induction (RSI) – also referred to as rapid sequence intubation or as rapid sequence induction and intubation (RSII) or as crash induction [1] – is a special process for endotracheal intubation that is used where the patient is at a high risk of pulmonary aspiration.
The Sellick maneuver was considered the standard of care during rapid sequence induction for many years. [3] The American Heart Association still advocates the use of cricoid pressure during resuscitation using a BVM, and during emergent oral endotracheal intubation. [4]
In many countries, cricoid pressure has been widely used during rapid sequence induction for nearly fifty years, despite a lack of compelling evidence to support this practice. [7] The initial article by Sellick was based on a small sample size at a time when high tidal volumes, head-down positioning and barbiturate anesthesia were the rule. [8]
Broselow tape is a tool used to help facilitate rapid and accurate equipment sizing decisions in pediatric emergency situations. Supraglottic airway devices, direct laryngoscopy, indirect video laryngoscopy, and fiberoptic intubation are all techniques which can be used to secure the pediatric airway.
Among all NMBA, Succinylcholine establish the most stable and fastest intubating conditions, thus is considered as the preferred NMBA for rapid sequence induction and intubation (RSII). [12] Alternatives for succinylcholine for RSII include high dose rocuronium (1.2mg/kg which is a 4 X ED95 dose), or avoidance of NMBAs with a high dose ...
Most modern protocols, including those of the American Heart Association, American Red Cross and the European Resuscitation Council, [5] recommend several stages, designed to apply increasingly more pressure. Most protocols recommend first encouraging the victims to cough, and allowing them an opportunity to spontaneously clear the foreign body ...
Rapid sequence intubation is incorrect (and is erroneously used in some manuals and courses), as it is the induction of anaesthesia that is rapid sequence, not the intubation, which is secondary to the procedure, and performed at normal speed, and used to maintain a patent airway after RSI is complete.
It is used for conscious sedation [7] [8] and as a part of a rapid sequence induction to induce anaesthesia. [9] [10] It is used as an anaesthetic agent since it has a rapid onset of action and a safe cardiovascular risk profile, and therefore is less likely to cause a significant drop in blood pressure than other induction agents.