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Rapid sequence induction: where did the consensus go?

Pascale Avery1, Sarah Morton2, James Raitt3

  • 1Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK. pascale.avery@nhs.net.

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
|May 14, 2021
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Summary
This summary is machine-generated.

Rapid Sequence Induction (RSI) for emergency airway intubation has evolved significantly from its original protocol. Modern RSI practices prioritize safety and effectiveness outside the operating room, adapting techniques and drugs while maintaining core principles.

Keywords:
Apnoeic oxygenationEmergency anaesthesiaGovernanceRapid sequence inductionStandard operating proceduresVideo laryngoscopy

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Area of Science:

  • Anesthesiology
  • Emergency Medicine
  • Critical Care

Background:

  • Rapid Sequence Induction (RSI) was developed to prevent gastric aspiration during emergency tracheal intubation.
  • Traditional RSI involved thiopentone, suxamethonium, and cricoid pressure.

Purpose of the Study:

  • To review modifications in Rapid Sequence Induction (RSI) techniques and practices.
  • To assess the evolution of safe and effective emergency anesthesia delivery outside the operating room.

Main Methods:

  • This study is a narrative review of Rapid Sequence Induction (RSI) practices.
  • It examines changes in training, technique, drugs, and equipment for RSI.

Main Results:

  • Key aspects of traditional RSI have been significantly challenged and altered.
  • RSI is now performed by multidisciplinary teams in diverse settings, including pre-hospital environments.

Conclusions:

  • Current RSI practices differ substantially from the original procedure.
  • The core principles of rapid definitive airway management and aspiration prevention remain critical for RSI.