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Endotracheal intubation carries with it many risks, particularly when paralytics are used, as maintenance of the airway becomes a challenge if intubation fails. It should therefore be attempted by experienced personnel, only when less invasive methods fail or when it is deemed necessary for safe transport of the patient, to reduce risk of ...
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.
This procedure is commonly performed by flight paramedics. Flight paramedics often use RSI to intubate before transport because intubation in a moving fixed-wing or rotary-wing aircraft is extremely difficult to perform due to environmental factors. The patient will be paralyzed and intubated on the ground before transport by aircraft.
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Basic treatment includes several procedures aiming at removing foreign bodies from the airways. Most protocols recommend encouraging the victim to cough, followed by hard back slaps, and if none of these things work; abdominal thrusts (Heimlich maneuver) or chest thrusts. [5]
A RSBI score of less than 65 [3] indicating a relatively low respiratory rate compared to tidal volume is generally considered as an indication of weaning readiness. A patient with a rapid shallow breathing index (RSBI) of less than 105 has an approximately 80% chance of being successfully extubated, whereas an RSBI of greater than 105 virtually guarantees weaning failure. [4]
In anesthesia, the Mallampati score or Mallampati classification, named after the Indian anaesthesiologist Seshagiri Mallampati, is used to predict the ease of endotracheal intubation. [1] The test comprises a visual assessment of the distance from the tongue base to the roof of the mouth, and therefore the amount of space in which there is to ...
Intubation first begins with the use of anesthesia medications, usually delivered through an IV, to place the patient to sleep. Next, extra oxygen is administered to the patient through a face mask. Once the patient is asleep, an anesthesia provider will tilt the patient’s head back and insert a viewing device, also known as a laryngoscope ...