Rapid sequence induction (RSI)

1. Rapid sequence induction (RSI)
Rawan alyemani

2. What is RSI ?
 It is a method of achieving rapid control of the airway while
minimizing the risk of regurgitation and aspiration of gastric
contents.
 Involve intravenous induction of anesthesia with application
of cricoid pressure, followed by the placement of an
endotracheal tube.

4. Drugs
 Hyponotics
 Propofol ( 1-3 mg/kg)
 Ketamine (1-2 mg/kg)
 Thiopentone (3-5 mg/kg)
 Midazolam (0.1-0.2 mg/kg)
 Nueromuscular blocking
 Suxamethonium (1-2 mg/kg)
 Rocuronium (0.9-1.6 mg/kg)
 Opioids
 Fentanyl (1-2 mcg/kg)
 Remifentanil (0.5-1 mcg/kg)

5. Cricoid pressure
 It is the application of force to the cricoid cartilage of the
patient.
 Aim to prevent passive reflux of gastric contents and
development of aspiration. By compress the area between
the trachea and the cervical vertebrae.
 Forced applied by the thumb and index finger ( 10 Newtons
force = 1 kg)
 Pressure maintained until endotracheal tube placment is
confirmed.

6. BURP

7. RSI technique
 Patient position for pre-oxygenation and intubation
 Intravenous cannula and fluid should run freely
 Drugs should be administered and observed for an effect
 Cricoid pressure is used ( 1 -3 kg at the moment
consciousness is lost)
 Once endotracheal tube is placed, the cuff is immediately
inflated and correct position should be confirmed.