Airway Management of the Critically Ill Patient: Modifications of Traditional Rapid Sequence Induction and Intubation
نویسنده
چکیده
Discussion about airway management is common amongst clinicians involved in critical care, regardless of background. The technique of rapid sequence induction and intubation (RSI) was described in 1970 and there are many accepted variations in modern day practice. Sadly this can lead to difficulty, particularly in the event of an airway misadventure, as clinicians may be subject to post hoc critique from expert opinion in other disciplines, and often held to a ‘standard’ of RSI that no longer exists. Experts may differ in opinions, and expertise in one arena may not translate to another. This paper outlines the variations in RSI practice and the rationale for deviation. Such discussion is necessary, as expert opinion referring to a ‘standard’ RSI may be inappropriate for the critically ill patient, exposing practitioners to medico-legal risk. Acknowledgement of variations in RSI practice allows the development of institutional procedures, with potential for future consensus recommendations guided by both published studies and expert opinion.
منابع مشابه
Airway management of the critically ill patient: rapid-sequence intubation.
Advances in emergency airway management have allowed intensivists to use intubation techniques that were once the province of anesthesiology and were confined to the operating room. Appropriate rapid-sequence intubation (RSI) with the use of neuromuscular blocking agents, induction drugs, and adjunctive medications in a standardized approach improves clinical outcomes for select patients who re...
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INTRODUCTION Rapid sequence induction (RSI) of critically ill patients outside of theatres is associated with a higher risk of hypoxia, cardiovascular collapse and death. In the prehospital and military environments, there is an increasing awareness of the benefits of standardised practice and checklists. METHODS We conducted a non-systematic review of literature pertaining to key components ...
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Airway management in critically ill patients remains a fundamental but challenging procedure, characterized by a high rate of complications. Studies have shown that as many as 40% of intubations in critical care settings are accompanied by severe adverse events,1,2 the most frequent complication being hypoxemia. A prospective study from critical care units in Scotland reported that severe hypox...
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