Rapid sequence induction: where did the consensus go?
Abstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review descr...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-021-00883-5 |
| _version_ | 1818453791290163200 |
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| author | Pascale Avery Sarah Morton James Raitt Hans Morten Lossius David Lockey |
| author_facet | Pascale Avery Sarah Morton James Raitt Hans Morten Lossius David Lockey |
| author_sort | Pascale Avery |
| collection | DOAJ |
| description | Abstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI – training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment. Conclusion The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles – rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged. |
| first_indexed | 2024-12-14T21:44:36Z |
| format | Article |
| id | doaj.art-96d77f93d1d64d8ab8e4fa43a3ed55da |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-14T21:44:36Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-96d77f93d1d64d8ab8e4fa43a3ed55da2022-12-21T22:46:23ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412021-05-012911910.1186/s13049-021-00883-5Rapid sequence induction: where did the consensus go?Pascale Avery0Sarah Morton1James Raitt2Hans Morten Lossius3David Lockey4Southmead Hospital, North Bristol NHS TrustEssex & Herts Air Ambulance, Flight HouseThames Valley Air Ambulance Stokenchurch HouseNorwegian Air Ambulance FoundationSouthmead Hospital, North Bristol NHS TrustAbstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI – training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment. Conclusion The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles – rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged.https://doi.org/10.1186/s13049-021-00883-5Rapid sequence inductionEmergency anaesthesiaStandard operating proceduresApnoeic oxygenationVideo laryngoscopyGovernance |
| spellingShingle | Pascale Avery Sarah Morton James Raitt Hans Morten Lossius David Lockey Rapid sequence induction: where did the consensus go? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Rapid sequence induction Emergency anaesthesia Standard operating procedures Apnoeic oxygenation Video laryngoscopy Governance |
| title | Rapid sequence induction: where did the consensus go? |
| title_full | Rapid sequence induction: where did the consensus go? |
| title_fullStr | Rapid sequence induction: where did the consensus go? |
| title_full_unstemmed | Rapid sequence induction: where did the consensus go? |
| title_short | Rapid sequence induction: where did the consensus go? |
| title_sort | rapid sequence induction where did the consensus go |
| topic | Rapid sequence induction Emergency anaesthesia Standard operating procedures Apnoeic oxygenation Video laryngoscopy Governance |
| url | https://doi.org/10.1186/s13049-021-00883-5 |
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