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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.
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Intubation (sometimes entubation) is a medical procedure involving the insertion of a tube into the body. Patients are generally anesthetized beforehand. Examples include tracheal intubation , and the balloon tamponade with a Sengstaken–Blakemore tube (a tube into the gastrointestinal tract ).
Sir Robert Macintosh (1897–1989) introduced a curved laryngoscope blade in 1943; [131] the Macintosh blade remains to this day the most widely used laryngoscope blade for orotracheal intubation. [10] Between 1945 and 1952, optical engineers built upon the earlier work of Rudolph Schindler (1888–1968), developing the first gastrocamera. [132]
Tracheal intubation is often performed for mechanical ventilation of hours to weeks duration. A tube is inserted through the nose (nasotracheal intubation) or mouth (orotracheal intubation) and advanced into the trachea. In most cases, tubes with inflatable cuffs are used for protection against leakage and aspiration.
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While Mallampati classes I and II are associated with relatively easy intubation, classes III and IV are associated with increased difficulty. 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 ...