COC RSI Flashcards
Definition of RSI
- Pre-oxygenation
- Administration of potent induction agent + rapidly acting neuromuscular blocking agent
- To induce unconsciousness + motor paralysis
Pros of RSI
x3
- Rapidly create controlled clinical environment for ETI
- Reduce stimulation of potentially harmful autonomic reflexes associated with ETI
- Reduce risk of aspiration
(by meds + cricoid pressure)
Difficult airway LEMON law
Look externally Evaluate 3-3-2 rule Mallampati score Obstruction Neck mobility
3-3-2 rule
3 finger mouth opening
3 finger mentum to hyoid
2 finger floor of mouth to thyroid cartilage
Mallampati classification
1: Soft palate + fauces + uvula + ant / posterior pillars
2: Soft palate + fauces + uvula
3: Soft palate + base of uvula
4: Cannot see soft palate
AMPLE history
Allergies Medication PMH Last meal Event
Neuro assessment before RSI
GCS
Pupil size, reaction
Localizing neurological signs
7 Ps of RSI
- Preparation
- Pre-oxygenation
- Pre-tx
- Paralysis with induction
- Protection and Position
- Placement with proof
- Post-intubation mx
Fentanyl for pre-treatment
1-3 ug/kg
60-180ug
Alfentanil for pre-treatment
- 01mg/kg
0. 6mg
Lignocaine for pre-treatment
1.5mg/kg
90mg
Atropine for pre-treatment
Infant: 0.02mg/kg (min 1mg)
Etomidate for induction
0.3mg/kg
(20mg)
*0.2mg/kg if pre-tx with opioid
Thiopental for induction
4mg/kg
(250mg)
*2mg/kg if hypotensive
Ketamine for induction
1-2mg/kg
100mg
