scholarly journals Introduction of a Rapid Sequence Induction Checklist and its effect on Compliance to Guidelines and Complications

2021 ◽  
Author(s):  
Jakob Zeuchner ◽  
Jonas Graf ◽  
Louise Elander ◽  
Jessica Frisk ◽  
Mats Fredrikson ◽  
...  
Keyword(s):  
Rapid Sequence Induction ◽  
Rapid Sequence ◽  
Sequence Induction

scholarly journals Rapid sequence induction: where did the consensus go?

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Pascale Avery ◽  
Sarah Morton ◽  
James Raitt ◽  
Hans Morten Lossius ◽  
David Lockey
Keyword(s):  
Cricoid Pressure ◽  
Rapid Sequence Induction ◽  
Hospital Environment ◽  
Training Technique ◽  
Rapid Sequence ◽  
Gastric Aspiration ◽  
Sequence Induction ◽  
The Uk ◽  
Key Aspects ◽  
Risk Of Aspiration

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.

COVID-19: Intensivmedizinische Aspekte und Langzeitfolgen

2020 ◽  
Author(s):  
Raphael Romano Bruno ◽  
Georg Wolff ◽  
Malte Kelm ◽  
Christian Jung
Keyword(s):  
Rapid Sequence Induction ◽  
High Flow ◽  
Ältere Personen ◽  
Rapid Sequence ◽  
Sind Eine ◽  
Sequence Induction ◽  
Thrombembolische Komplikationen ◽  
Invasive Beatmung

ZusammenfassungEtwa 14% der COVID-19-Patienten weisen einen schwereren und ca. 5% einen kritischen Krankheitsverlauf auf. Besonders gefährdet sind ältere Personen, männliches Geschlecht, Raucher und stark adipöse Menschen. Wird der Patient invasiv oder nichtinvasiv beatmet, so steigt die Mortalität auf 53% respektive 50% an. In der Regel beträgt die Dauer vom Beginn der Symptome bis zur Aufnahme auf die Intensivstation 10 Tage. Die mittlere Verweildauer auf der Intensivstation beträgt 9 Tage. Für die Priorisierung sind die klinische Erfolgsaussicht einer intensivmedizinischen Behandlung sowie der Wunsch des Patienten maßgebend. Zentrale Kriterien für die Aufnahme auf die Intensivstation sind eine Hypoxämie (SpO2 < 90% unter 2 – 4 Liter Sauerstoff/min bei nicht vorbestehender Therapie), Dyspnoe, eine erhöhte Atemfrequenz (> 25 – 30/min) und ein systolischer Blutdruck ≤ 100 mmHg. Der Schutz des Personals genießt bei allen Maßnahmen Vorrang. Alle aerosolgenerierenden Prozeduren sollten nur mit großer Vorsicht erfolgen. Wird unter High Flow keine adäquate Oxygenierung erreicht (SpO2 ≥ 90% oder ein paO2 > 55 mmHg), sollte über eine Eskalation nachgedacht werden (NIV, invasive Beatmung). Die Patienten sollten lungenprotektiv beatmet werden. Die Intubation sollte als Rapid Sequence Induction erfolgen. Eine ECMO kann erwogen werden. Thrombembolische Komplikationen sind sehr häufig. Antibiotika sollten nicht routinemäßig gegeben werden. Die aktuell beste Datenlage liegt für Dexamethason vor. Remdesivir kann die Rekonvaleszenz beschleunigen. Langzeitfolgen nach COVID-19 sind sehr häufig. Kardiale, pulmonale und neurologische Probleme stehen dabei im Vordergrund.

Fentanyl-Droperidol Supplementation of Rapid Sequence Induction in the Presence of Severe Pregnancy-Induced and Pregnancy-Aggravated Hypertension

1988 ◽  
Vol 8 (2) ◽  
pp. 75
Author(s):  
E. G. Lawes ◽  
J. W. Downing ◽  
P. W. Duncan ◽  
B. Bland ◽  
N. Lavies ◽  
...  
Keyword(s):  
Rapid Sequence Induction ◽  
Rapid Sequence ◽  
Sequence Induction

Bag-mask ventilation in rapid sequence induction

2015 ◽  
Vol 32 (6) ◽  
pp. 446-448 ◽  
Author(s):  
James P.R. Brown ◽  
Gavin C. Werrett
Keyword(s):  
Rapid Sequence Induction ◽  
Mask Ventilation ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
Bag Mask Ventilation

Comparison of Plastic Single-use and Metal Reusable Laryngoscope Blades for Orotracheal Intubation during Rapid Sequence Induction of Anesthesia

2006 ◽  
Vol 104 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Julien Amour ◽  
Frédéric Marmion ◽  
Aurélie Birenbaum ◽  
Armelle Nicolas-Robin ◽  
Pierre Coriat ◽  
...  
Keyword(s):  
Rapid Sequence Induction ◽  
Orotracheal Intubation ◽  
Failed Intubation ◽  
Cluster Randomization ◽  
Rapid Sequence ◽  
Lehane Grade ◽  
Sequence Induction ◽  
Single Use ◽  
S Period ◽  
Laryngoscope Blades

Background Plastic single-use laryngoscope blades are inexpensive and carry a lower risk of infection compared with metal reusable blades, but their efficiency during rapid sequence induction remains a matter of debate. The authors therefore compared plastic and metal blades during rapid sequence induction in a prospective randomized trial. Methods Two hundred eighty-four adult patients undergoing general anesthesia requiring rapid sequence induction were randomly assigned on a weekly basis to either plastic single-use or reusable metal blades (cluster randomization). After induction, a 60-s period was allowed to complete intubation. In the case of failed intubation, a second attempt was performed using metal blade. The primary endpoint of the study was the rate of failed intubations, and the secondary endpoint was the incidence of complications (oxygen desaturation, lung aspiration, and oropharynx trauma). Results Both groups were similar in their main characteristics, including risk factors for difficult intubation. On the first attempt, the rate of failed intubation was significantly increased in plastic blade group (17 vs. 3%; P &lt; 0.01). In metal blade group, 50% of failed intubations were still difficult after the second attempt. In plastic blade group, all initial failed intubations were successfully intubated using metal blade, with an improvement in Cormack and Lehane grade. There was a significant increase in the complication rate in plastic group (15 vs. 6%; P &lt; 0.05). Conclusions In rapid sequence induction of anesthesia, the plastic laryngoscope blade is less efficient than a metal blade and thus should not be recommended for use in this clinical setting.

Rapid sequence induction: a national survey of practice

Anaesthesia ◽  
2001 ◽  
Vol 56 (11) ◽  
pp. 1090-1115
Author(s):  
J. Morris ◽  
T. M. Cook
Keyword(s):  
National Survey ◽  
Rapid Sequence Induction ◽  
Rapid Sequence ◽  
Sequence Induction
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