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Rapid Sequence Intubation. Trigger 1. Rapid Sequence Intubation Definition. Rapid Sequence Intubation ( RSI, also known as Rapid Sequence Induction ) . Rapid Sequence Intubation Definition. Rapid Sequence Intubation ( RSI, also known as Rapid Sequence Induction )

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rapid sequence intubation definition
Rapid Sequence IntubationDefinition

Rapid Sequence Intubation (RSI, also known as Rapid Sequence Induction)

rapid sequence intubation definition3
Rapid Sequence IntubationDefinition

Rapid Sequence Intubation (RSI, also known as Rapid Sequence Induction)

  • refers to a specific method of general anaesthesia that can be used in emergency situations.
rapid sequence intubation definition4
Rapid Sequence IntubationDefinition

Rapid Sequence Intubation (RSI, also known as Rapid Sequence Induction)

  • refers to a specific method of general anaesthesia that can be used in emergency situations.
  • it facilitates intubation while preventing gastric aspiration and protecting against increased intracranial pressure.
rapid sequence intubation trauma challenges
Rapid Sequence IntubationTRAUMA CHALLENGES

Trauma presents special challenges to airway management.

  • The patient's cervical spine, for example, must be immobilized until a thorough assessment of its stability can be completed.
  • The ability to open the patient's jaw may be limited, and there may be upper airway oedema, penetrating neck injuries, facial or laryngeal trauma
  • Loss of integrity of the airway structure, and obscured visibility of the passageway.
rapid sequence intubation trauma challenges6
Rapid Sequence IntubationTRAUMA CHALLENGES
  • The team should be aware that restlessness or aggression can result from hypoxia or a patient's drug and alcohol use and should therefore assess for hemodynamic compromise and traumatic brain injury
rapid sequence intubation aspects of intubation
Rapid Sequence IntubationASPECTS OF INTUBATION

RSI offers the trauma team the quickest way to secure and manage the patient's airway.

rapid sequence intubation aspects of intubation8
Rapid Sequence IntubationASPECTS OF INTUBATION

The essential aspects of intubation are:

  • Communication with the patient
  • Preoxygenation
  • Sedation (when appropriate)+analgisic
  • Application of cricoid pressure
  • Paralysis (muscle relaxation)
  • Placing the tube/confirming placement
  • Patient monitoring
rapid sequence intubation aspects of intubation12
Rapid Sequence IntubationASPECTS OF INTUBATION
  • After intubation an orogastric or nasogastric tube should be inserted and chest x-ray taken to confirm placement of the tube in the stomach.
  • The unconscious patient requires eye care, pressure area care, temperature control and catheterisation of the urinary bladder.
rapid sequence intubation hypotension following intubation
Rapid Sequence IntubationHYPOTENSION FOLLOWING INTUBATION
  • causes include vasodilator and/or negative inotropic effects of the sedative drug and/or positive pressure ventilation decreasing venous return and cardiac output.
  • treatment consists of fluid challenge and/or inotrope administration depending on the clinical setting.
rapid sequence intubation hypotension following intubation14
Rapid Sequence IntubationHYPOTENSION FOLLOWING INTUBATION
  • Rarely hypotension may be due to tension pneumothorax occurring after the commencement of positive pressure ventilation.
rapid sequence intubation hypertension following intubation
Rapid Sequence IntubationHYPERTENSION FOLLOWING INTUBATION
  • Hypertension usually indicates inadequate sedation
  • Should be treated with supplemental sedation.
rapid sequence intubation nursing implications
Rapid Sequence IntubationNURSING IMPLICATIONS

Nurses are active participants in the assessments, diagnosis, planning, and interventions pertaining to airway management. As such, they must remember to:

rapid sequence intubation nursing implications17
Rapid Sequence IntubationNURSING IMPLICATIONS

* make a baseline assessment that includes information on the patient's level of consciousness and hemodynamic status (blood pressure, pulse, respirations, temperature, oxygen saturation, circulation status [including quality of pulse and skin color], and cardiac rhythm).

* begin continuous cardiac monitoring and pulse oximetry.

rapid sequence intubation nursing implications18
Rapid Sequence IntubationNURSING IMPLICATIONS

* insert at least one large-bore iv catheter to deliver fluids (two large-bore iv catheters are recommended for trauma patients).

* provide patient and family education and support.

* ensure the availability of all intubation and resuscitation equipment.

rapid sequence intubation nursing implications19
Rapid Sequence IntubationNURSING IMPLICATIONS

* determine and document which drugs and interventions are used and note when the desired effect was obtained (for example, when muscle relaxation and intubation occurred).

* assess the patient's response to each medication and intervention

* consider inserting an arterial line or obtaining ABG measurements to provide accurate, continuous monitoring of oxygen saturation

rapid sequence intubation nursing implications20
Rapid Sequence IntubationNURSING IMPLICATIONS

Nurses can improve the efficiency with which airway management occurs by learning about the risks and complications of intubation, becoming familiar with the pharmaceutical agents used in RSI, as well as their potential side effects, and by learning how to assess and monitor the needs of each trauma patient.