Rapid sequence induction
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Rapid sequence induction book
Rapid sequence induction, or rapid sequence intubation (RSI) is an established method of inducing anaesthesia in patients who are at risk of aspiration of gastric contents into the lungs. The basic principle is intubation of the trachea during application of cricoid pressure following loss of consciousness. The main objective of the technique is to minimise the time interval between loss of protective airway reflexes and tracheal intubation with a cuffed endotracheal tube. During emergency intubation, aspiration of stomach contents is a potential risk in all patients with an incompetent larynx. Pre-intubation fasting and pro-kinetic agents reduce this risk but are not always appropriate or available before emergency intubation and ventilation. RSI as a practice is not without risk, particularly in the critically ill patients. Risks include hypoxia, failed intubation, oesophageal trauma, cardiovascular compromise and awareness.