Projects

The most important task of an emergency physician managing an
acutely unstable patient is to secure the airway.1 Rapid sequence
induction (RSI) is the technique of choice for emergency airway
management of all patients except in anticipated difficult airways.
Prevention of aspiration, rapid and safe achievement of intubation,
and preparation for the possibility of failure of securing the airway
are the immediate goals.
In the prehospital setting, there is variable access to expertise
and equipment. There is always increased mortality associated
with prehospital intubation caused by suboptimal intubation
performance.
The classical approach to RSI, as advocated by Stept and Safar
describe certain essential features:2
• Preoxygenation with 100% oxygen.
• Administration of a predetermined induction dose.
• Application of cricoid pressure and avoid bag and mask
ventilation.
• Intubation with a cuffed tracheal tube.
• Specialized equipment for management in the event of a failed
intubation.