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Rapid Sequence Intubation(RSI) Ryuhei IGETA 1 , Kentaro OKAMOTO 1 1Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine pp.669-682
Published Date 2019/10/1
DOI https://doi.org/10.11477/mf.3102200682
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Critically ill patients frequently require endotracheal intubation in the intensive care unit (ICU) or in the emergency department (ED). They differ from typical elective surgical patients intubated in the operating room because of insufficient patient information, lack of time, and the severity of their illness. RSI is commonly used for airway management and we need to be familiar with the technique. The purpose of RSI is to make emergent intubation easier and safer, thereby increasing the success rate of intubation and decreasing the rate of complications. RSI uses a rapidly acting agent and a neuromuscular blocking agent to create optimal conditions for intubation enabling rapid control of the airway. RSI generally consists of seven steps known as the “Seven Ps of RSI”:(1) Preparation, (2) Preoxygenation, (3) Preintubation optimization, (4) Paralysis with induction, (5) Positioning, (6) Placement with proof, and (7) Postintubation management. The most important contraindication to RSI is anticipation of a difficult airway especially if there is a risk of “Cannot Ventilate, Cannot Intubate (CVCI)”. With appropriate risk assessment and careful preparation, we can maximize the success rate of the first attempt and minimize the incidence of complications.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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