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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 Manoeuvre is typically only applied during a Rapid Sequence Induction (RSI), an induction technique reserved for those at high risk of aspiration. [citation needed] The Sellick maneuver was considered the standard of care during rapid sequence induction for many years. [3]
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]
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.
Rapid sequence induction and intubation (RSI) is a particular method of induction of general anesthesia, commonly employed in emergency operations and other situations where patients are assumed to have a full stomach.
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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 ...
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