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Age can play a role in whether or not the procedure is warranted, and is commonly needed in younger persons. [40] The clinician that performs Rapid Sequence Induction and Intubation (RSII) must be skilled in tracheal intubation and also in bag valve mask ventilation. Alternative airway management devices must be immediately available, in the ...
Basic airway management is a concept and set of medical procedures performed to prevent and treat airway obstruction and allow for adequate ventilation to a patient's lungs. [1] This is accomplished by clearing or preventing obstructions of airways. Airway obstructions can occur in both conscious and unconscious individuals.
Tracheal intubation, often simply referred to as intubation, is the placement of a flexible plastic or rubber endotracheal tube (ETT) into the trachea to maintain an open airway, allow for effective ventilation, protect the airway from aspiration (when a cuffed ETT is used), and to serve as a conduit through which to administer inhaled anesthetics.
In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
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 ...
Cricoid pressure, also known as the Sellick manoeuvre or Sellick maneuver, is a technique used in endotracheal intubation to try to reduce the risk of regurgitation.The technique involves the application of pressure to the cricoid cartilage at the neck, thus occluding the esophagus which passes directly behind it.
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.
Intubation with a cuffed tube is thought to provide the best protection against aspiration. Downside of tracheal tubes is the pain and coughing that follows. Therefore, unless a patient is unconscious or anesthetized, sedative drugs are usually given to provide tolerance of the tube.