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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.
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]
A cricothyrotomy is often used as an airway of last resort given the numerous other airway options available including standard tracheal intubation and rapid sequence induction which are the common means of establishing an airway in an emergency scenario. [2]
Regardless of the laboratory values, these guidelines are always interpreted in the clinical context. [6] ... Rapid sequence induction and intubation (RSI) is a ...
The Sellick maneuver was considered the standard of care during rapid sequence induction for many years. [3] The American Heart Association still advocates the use of cricoid pressure during resuscitation using a BVM , and during emergent oral endotracheal intubation. [ 4 ]
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 ...
Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness.It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world.
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.