Rapid Sequence Induction Explained

airway management aspiration risk cricoid pressure intubation rapid sequence induction Jun 06, 2023

The standard way of starting an anaesthetic involves preoxygenation, giving drugs, mask ventilation until the muscle relaxant has taken effect, and intubation. 💉😮‍💨✔️

A Rapid Sequence Induction (RSI) is slightly different ☝🏻

Here’s how:

It is used in patients at risk of aspiration. They include:

👉🏻Unfasted patients
👉🏻Patients with severe reflux
👉🏻Patients who have a reason for delayed gastric emptying (trauma, emergency cases, bowel obstruction)

How is it performed?

A “true” RSI has the following characteristics:

1️⃣Cricoid pressure is applied

As it theoretically compresses the oesophagus and prevents regurgitation

2️⃣Mask ventilation is AVOIDED

As it theoretically increases aspiration risk

3️⃣Suxamethonium is the muscle relaxant of choice

As it provides rapid paralysis with a clear end point (fasciculations)

However, a “modified” RSI is also very common:

👉🏻Cricoid may not be used
👉🏻Gentle mask ventilation may still be performed
👉🏻Rocuronium may be used

The ultimate goal is to safely intubate the patient, avoid desaturation, and prevent aspiration. If your team can achieve that, the exact technique doesn’t matter 👏👌

Check out our reel on cricoid pressure for more information! 🤓

Build knowledge ✅
Improve safety ✅

Stay connected with news and updates!

Join our mailing list to receive the latest news and updates from our team.
Don't worry, your information will not be shared.

We hate SPAM. We will never sell your information, for any reason.

Want to keep learning?

Want more content like this? Check out our premium membership for exclusive content. 

Click Here for Access

 

 

Join our mailing list for free weekly educational content.

 

By entering your details you consent to receiving amazing educational materials and updates about our products and events.