Hi folks - I have a clinical question for those in school and practicing. I've just been introduced to RSI (in the ER), and was wondering if you could explain a few things to me. Can you tell me what the difference is between this method and previous methods? Most of the intubations I've seen from my ER days were done on non-breathing patients, so pre-medication was not an issue, but it seems to me that gas-passers have always done elective intubations in this way - preoxygenation, premedication, paralyze, and pass the tube. What am I missing here?
Thanks for the insight - Doug
Oct 5, '02
The purpose of rapid sequence intubation is to decrease the risk of aspiration in patients who are at risk. Therefore, the goal is to get them sedated, paralyzed and intubated as quickly as possible. So, rapid paralytic (succs)(plus all the other drugs) no interim ventilations, cricoid pressure.
Opposed to standard intubation, where you can use slower paralytics, ventilate while waiting for the paralytic to take effect. May or may not use cricoid pressure.
Some people do a modified RSI, where they will provide ventilatory support or change some other aspect of the RSI protocol. Some of the students in my class or doing a survey to see how wide spread modification is.