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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.
Various expert societies in airway management, including the American Society of Anesthesiologists, have recommended approaches to difficult airways. The algorithm provides a step-by-step framework to respond to situations where traditional airway management techniques may be inadequate.
The anaesthesia community had been calling for practice guidelines and in 1992 the ASA commissioned a task force to establish practice guidelines for managing difficult airway situations. The ASA algorithm for difficult airways was published in 1993 and stressed an early attempt at insertion of the laryngeal mask if face mask ventilation was ...
A systematic review of 42 studies, with 34,513 participants, found that the modified Mallampati score is a good predictor of difficult direct laryngoscopy and intubation, but poor at predicting difficult bag mask ventilation.
The Simplified Airway Risk Index (SARI), or El-Ganzouri Risk Index (EGRI), is a multivariate risk score thought to estimate the risk of difficult tracheal intubation. The SARI score ranges from 0 to 12 points, where a higher number of points indicates a more difficult airway. A SARI score of 4 or above is thought to indicate a difficult ...
Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents . [citation needed] Airway management is commonly divided into two categories: basic and advanced.
Tracheal intubation in the emergency setting can be difficult with the fiberoptic bronchoscope due to blood, vomit, or secretions in the airway and poor patient cooperation. Because of this, patients with massive facial injury, complete upper airway obstruction, severely diminished ventilation, or profuse upper airway bleeding are poor ...
[13] [14] The double-lumen laryngeal tube-Suction II, with the possibility of placing a gastric tube, has been found to have distinct advantages over the standard laryngeal tube and has been recommended as a first-line device to secure the airway in emergency situations when direct laryngoscopy fails in neonates and infants. [15]