Some add a 10th P for (cricoid) pressure after pretreatment but this procedure is optional and has many drawbacks (see Cricoid Pressure) Positioning (some do this after paralysis and induction).Preparation (drugs, equipment, people, place).Secretions, blood, vomitus, and distorted anatomy.
#RAPID SEQUENCE INTUBATION GUIDELINES 2013 FULL#
Full stomach (increased risk of regurgitation, vomiting, aspiration).Dynamically deteriorating clinical situation, i.e., there is a real “need for speed”.RSI is useful if the following are present (from Richard Levitan’s ): neck trauma, tumour)įACTORS THAT MAKE EMERGENCY INTUBATION DIFFICULT emergency surgical airway is not possible (e.g.paediatric cases (especially congenital deformity, laryngeal fracture) urgent need to OT and theatre is available anatomically or pathologically difficult airway (e.g.cervical spine injury (diaphragmatic paralysis).major trauma requiring multiple interventions) Lack of airway protection despite patency (swallow, gag, cough, positioning, and tone)hypoxia.The decision to perform RSI in the ‘out of theatre’ setting involves weighing the pros and cons: procedures) and for safety during transport (e.g. D – unresponsive to pain, terminate seizure, prevent secondary brain injury.C – minimise oxygen consumption and optimize oxygen delivery (e.g.B – respiratory failure (hypercapnic or hypoxic), increase FRC, decrease WOB, secretion management/ pulmonary toilet, to facilitate bronchoscopy.INDICATIONS FOR INTUBATION AND MECHANICAL VENTILATION prevent respiratory acidosis due to apnea from compounding severe metabolic acidosis) ventilation during apnea, titration of induction agents) modified approaches tend to trade an increased risk of aspiration for other benefits (e.g. ‘modified’ RSI is a term sometimes used to describe variations on the ‘classic’ RSI approach (e.g.RSI is particularly useful in the patient with an intact gag reflex, a “full” stomach, and a life threatening injury or illness requiring immediate airway control.
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