Is there a failure of ventilation or oxygenation 3. Is there a failure of airway maintenance or 2. For this reason, the implementation of RSI in the pre-hospital environment is supported, provided that it is practised within an appropriate framework of clinical governance. The Sequence First of all the decision to intubate should be based on three fundamental assessments: 1. In the emergency department setting, RSI is superior to intubation with deep sedation, a technique not incorporating pharmacological paralysis as part of the intubation sequence. The rapid sequence intubation (RSI) is a technique developed to rapidly secure the airway, maximally reducing the time interval between the loss of the. There is controversy regarding the choice of induction drug, the dose, and the method of administration. As soon as her blood pressure is adequate, I would pursue rapid-sequence intubation with rocuronium (1.4 mg/kg) and a sub-dissociative 0.5 mg/kg dose of ketamine (2). RSI has become widespread as the procedure of choice for definitive airway management by pre- and in-hospital emergency care personnel worldwide. The changing opinion regarding some of the traditional components of rapid sequence induction and intubation (RSII) creates wide practice variations that impede attempts to establish a standard RSII protocol. Features of this technique include pre-oxygenation, rapid pharmacological induction of unconsciousness, and neuromuscular blockade to enable the placement of an endotracheal tube. The box on the lower right-hand side of the graph depicts time to recovery from succinylcholine, which in almost all cases exceeds safe. Children, patients with comorbidity, and obese patients desaturate much more rapidly than healthy, normal adults. RSI is an advanced airway management process that facilitates endotracheal intubation in adults and children. Rapid Sequence Intubation Figure 1-9 Desaturation time for apneic, fully preoxygenated patients. RAPID SEQUENCE INTUBATION HOW TOThe Professional Board for Emergency Care at the Health Professions Council of South Africa (HPCSA) has approved pre-hospital rapid sequence intubation (RSI) as part of the scope of practice for registered emergency care practitioners (ECPs). Rapid Sequence Intubation (RSI) for Patients with COVID-19 Practice Purpose To provide practical guidance to health care professionals about how to safely perform an RSI for patients with COVID-19.
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