What Do You Know About Rapid Sequence Induction?

Rapid sequence induction (RSI) refers to an orotracheal intubation. This procedure is usually performed in the emergency room. In order to succeed, however, it is necessary to follow a series of orderly steps that can endanger the patient’s life if they are skipped.

As one study states: “ For the medical specialist in emergency medicine, the management of the airways in prehospital care units and emergency services is a crucial part of their basic competence. ”

It is therefore important that doctors know how to perform a rapid induction. This will reduce the risk of lung aspiration in some patients.

When do doctors perform rapid sequence induction ?

People need RSI when they arrive at the emergency room with an imminent risk of shortness of breath. A quick evaluation will prevent doctors from performing the procedure without precision.

The consequences of performing a rapid sequence induction can range from hypoxemia to causing airway damage when the orotracheal tube is inserted. It is therefore important to be calm and follow the steps accurately.

In some cases it is not clear when orotracheal intubation is to be performed. However, when there is a possibility that the patient may need it, the doctor will perform it.

However, the following symptoms should be considered. They can clearly indicate the need for a rapid sequence induction :

• Swollen hematoma in the neck
• Chest pain with hypotension

• Extensive burns
• Obstruction of the respiratory tract
• Myocardial infarction

If the patient in addition to all this is agitated because they can not breathe normally, they will need immediate sedation. After this, your doctor should perform RSI as soon as possible.

Proper procedure

To perform a successful intubation, a series of steps must be followed. Doctors will perform these steps in a smooth, fast and precise manner. In this way, they will be able to avoid some of the consequences that we mentioned earlier.

Actions before intubation

• First, they raise the patient’s head by placing a pillow underneath.

• Then they lift the jaw by pushing it up and forward.
• Furthermore, they remove foreign bodies from the mouth and throat.
• They also remove all secretions (blood, vomit).

Rapid sequence induction

• First, they hold the laryngoscope with one hand and insert it through the corner of the mouth, moving the tongue and moving the laryngoscope forward and upward.
• Place the tip of the instrument in the larynx.
• To reduce the risk of aspiration or regurgitation, another professional must perform the Sellick maneuver. They must do this within the duration of the intubation.
• In case the glottis or vocal cords are not very visible, another person should perform the BURP maneuver to expose them. This will allow doctors to position the laryngoscope correctly without damaging the airways.

• When the doctor inserts the tube correctly, they will remove the laryngoscope without moving the tube . They will then fix and connect it to the oxygen source.

Although we recommended using the Sellick and BURP maneuvers, these should never be used if the patient suffers from trauma or has a foreign body in the trachea. This is very important to keep in mind.

Rapid sequence induction : medication

In general, the use of medication is not necessary when performing RSI. However, there are cases where it would be impossible to intubate the patient without these drugs.

When a patient is restless, it is necessary to give them a sedative. In other cases, when the patient is in severe pain, one should also give them a painkiller in addition to a sedative.

There are a few circumstances where doctors need to give patients a micro-relaxing agent. This is important when the tube cannot pass through the trachea due to pressure.

As you can see, induction is a procedure that all professionals working in the emergency room should know how to perform properly. In this way, they can ensure that the patient will experience the least possible damage to the airways.

In addition, it is important to know the medications they will use in certain situations. Rapid sequence induction is definitely an important first aid measure.