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Published on: February 22, 2016
Rapid sequence induction and intubation: current controversy.
Mohammad El-Orbany1, Lois A Connolly
1Department of Anesthesiology-West, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee, WI 53226, USA. elorbany@mcw.edu
Anesthesia and Analgesia
|March 19, 2010
Summary
Standardizing rapid sequence induction and intubation (RSII) is challenging due to ongoing debates on induction drugs, neuromuscular blocking drugs (NMBDs), and cricoid pressure, leading to varied clinical practices.
Area of Science:
- Anesthesiology
- Critical Care Medicine
Background:
- Rapid sequence induction and intubation (RSII) practices vary widely due to evolving opinions on traditional components.
- Lack of a standardized protocol hinders consistent patient care during emergency airway management.
Purpose of the Study:
- To review and discuss controversial aspects of RSII.
- To identify areas needing further research for establishing a standard RSII protocol.
Main Methods:
- Review of current literature and clinical practices regarding RSII components.
- Analysis of controversies surrounding induction agents, neuromuscular blocking drugs (NMBDs), ventilation, and cricoid pressure.
Main Results:
- Significant debate exists regarding induction drug choice, dosage, administration, and NMBD timing.
- Controversies persist on optimal succinylcholine dosage, defasciculation, and priming techniques.
- Practices concerning pre-intubation ventilation and cricoid pressure application show considerable variation.
Conclusions:
- Resolving controversies in RSII components is crucial for developing a standardized protocol.
- Further research is needed to address variations in drug administration, ventilation strategies, and patient positioning.
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