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Use of modified rapid sequence tracheal intubation in pediatric patients

Claude Abdallah1, Raafat Hannallah1

  • 1Division of Anesthesiology, Children's National Medical Center, NW, Washington D.C. 20010 - 2970, USA.

Saudi Journal of Anaesthesia
|May 21, 2014
PubMed
Abstract

Insights

Pediatric anesthesiologists have varied definitions and techniques for modified rapid sequence intubation (MRSI). The primary reason for using MRSI is concern over apnea time tolerance during traditional rapid sequence intubation (RSI).

Area of Science:

  • Pediatric Anesthesiology
  • Airway Management

Background:

  • Rapid sequence intubation (RSI) is standard but carries risks.
  • Modified rapid sequence intubation (MRSI) may be more appropriate in certain situations.
  • A clear definition and understanding of MRSI are lacking.

Purpose of the Study:

  • To determine the working definition of MRSI.
  • To understand the current practices and modalities of MRSI use.

Main Methods:

  • A descriptive survey was conducted among pediatric anesthesiologists.
  • Questions covered experience, practice setting, and MRSI utilization.
  • Responses were analyzed to define MRSI, its techniques, indications, and complications.

Main Results:

  • 228 pediatric anesthesiologists responded, with an average of 14.9 years in practice.
  • 65% equated MRSI to RSI with mask ventilation.
  • The main indication for MRSI was concern about apnea time tolerance (74%).

Conclusions:

  • The technique for modified rapid sequence intubation (MRSI) is not standardized among pediatric providers.
  • Variability exists in the definition and application of MRSI in pediatric anesthesia.
Keywords:
Airwayendotrachealintubationpediatricssurveytechnique

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