Rapid Sequence Induction and Intubation

Abstract

The modern version of RSI starts with preoxygenation. General anaesthesia is then induced using a rapid acting intravenous anaesthetic and a rapid acing muscle relaxant. Cricoid pressure is applied by an experienced assistant during induction, which should then be maintained until the trachea of the patient is intubated, correct positioning of the tracheal tube confirmed and the cuff inflated. The patient is conventionally not ventilated during this phase but critically ill patients are exceptions. The patient's tracheal should be intubated when adequately paralysed and its position verified. The assistant can then relieve the cricoid pressure and the tracheal tube fixed.