Context
Intubation forms an integral role in the treatment of the critically ill or injured patients presenting to the ED with a failed or at-risk airway. The acuity of their presentation may often necessitate a rapid placement of an endotracheal tube (ETT). There are many different strategies to achieve this; one such technique is rapid sequence induction (RSI). RSI is designed to minimise the time between loss of airway reflexes and placement of an ETT in the trachea. It minimises the risk of aspiration in patients who are inadequately starved, have impaired gastric emptying or are known to have gastric reflux. The term ‘rapid sequence induction’ emphasises the use of a sequential technique in achieving rapid intubation by minimising the time delay between loss of airway reflexes and tube placement.
Definition
The traditional definition of rapid sequence induction (RSI) is an established method of inducing anaesthesia in patients who are at risk of aspiration of gastric contents into the lungs. It involves inducing loss of consciousness whilst cricoid pressure is applied followed by placement of an endotracheal tube.