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AA's Rapid Sequence Induction Tips

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JCole View Drop Down
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Joined: 03 Oct 2007
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    Posted: 05 Sep 2009 at 4:06pm
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Rapid Sequence Induction



The rapid sequence induction or RSI is popular for patients undergoing emergency surgery. It is a technique for induction of anesthesia in a patient suspected to be at risk aspiration. The classic rapid sequence induction involves the use of thiopentone and suxamethonium

Aims

The aim of the rapid sequence induction is to minimize the interval loss of airways protective reflexes and intubation, thus reducing the opportunity for aspiration.

Indications

It is indicated wherever it is suspected that there is a risk of aspiration

    * Bowel obstruction
    * Recent oral food or liquids
    * Unknown time of last meal
    * Delayed gastric emptying, due to opioids, pain, hyperglycaemia or alcohol
    * Loss of protective reflexes;reduced level of consciousness or neuromuscular disease
    * Pregnancy
    * Anticipated difficult airway

Technique

The patient should be counseled if possible of the intention to perform a rapid sequence induction. They should be informed of the reason for the rapid sequence, the method of pre-oxygenation, cricoid pressure and also the side effects of suxamethonium (muscle aches) Preparation is important and the anesthetist should ensure that there are the presence of

    * Trained anesthetic assistant
    * Tipping trolley
    * Suction
    * Selection fo laryngoscopes
    * Selection of endotracheal tubes and airway adjuncts
    * Full monitoring facilities including capnography
    * Large bore, fast flowing drip
    * Anesthetic machine
    * Resuscitation equipment
    * Predetermined doses of drugs for induction and emergency drugs
    * Strategy for complications- failed intubation drill

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Edited by JCole - 05 Sep 2009 at 4:09pm
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