What Is The Induction Of Rapid Sequence? The alteration of the airways can lead to the death of a patient. Therefore, the induction of rapid sequence can be the key to saving many lives.
The induction of rapid sequence refers to orotracheal intubation and usually carried out in the emergency department.
However, in order to be successful, it is necessary to follow a series of orderly steps that, if skipped, can put the patient’s life at risk. As one study indicates, “for the medical specialist in emergency medicine, the management of the airway in the Prehospital Care Units.
And Emergency Services is a fundamental part of their basic competencies”. Therefore, doctors know how to perform a rapid sequence induction is essential to reduce the risk of pulmonary aspiration that some patients may have.
What Is The Induction Of Rapid Sequence
The induction of rapid sequence arises when a patient arrives at the emergency room with an imminent risk of ventilatory failure.
An evaluation without waiting and agile will prevent this procedure from being carried out with precision.
Therefore, keep calm and be clear about the steps that must follow is very important. Although in some cases it is not clear when orotracheal intubation should perform.
This allows the induction of rapid sequence, when there are suspicions that the patient will not be able to keep the airways open, it should perform. However, the following symptoms take into account, which can clearly indicate the need for a rapid sequence induction:
- Swollen hematoma in the neck.
- Thoracic trauma with hypotension.
- Extensive burns
- Obstruction of the airway.
- Heart attack.
If, in addition to all this, the patient agitate because he is not able to breathe normally and requires immediate sedation. The induction of rapid sequence should practice as soon as possible.
The Correct Way To Proceed
In order to perform successful intubation, a series of steps must follow that will carried out in an agile, fast, and precise manner. In this way, some of the consequences mentioned above will avoided.
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Pre-intubation Actions
- Raise the patient’s head by placing a pillow underneath.
- Lift the jaw by pushing it up and forward.
- Remove any foreign body from the oropharyngeal cavity.
- Aspirate all secretions (blood, vomit).
Maneuvers of Rapid Sequence Induction
- Hold the laryngoscope with one hand and insert through the corner of the mouth, moving the tongue and bringing the laryngoscope forward and up.
- Place the tip of this instrument in the epiglottis.
- To reduce the risk of aspiration or regurgitation, another professional must perform the Sellick maneuver. This must be done during the duration of the intubation.
- In the event that the glottis or vocal cords do not look good, another person must perform the BURP maneuver to expose it. This will allow introducing the laryngoscope properly and avoid injuring the airway.
- When the tube is correctly inserted, the laryngoscope is removed without moving the tube. This will be fixed and connected to the oxygen source.
Although we have recommended the maneuvers of Sellick and BURP, these should never be carried out in the event that the patient suffers some trauma or has a foreign body in the trachea. This is necessary to take it into account.
Drugs
In general, the use of any drug is not necessary when the induction of a rapid sequence is performed. However, there are cases in which, without the supply of these medications, it would be impossible to intubate the patient.
When a patient is restless, it is necessary to provide sedative medication. In other cases, when suffering from severe pain, in addition to the sedative you should be given an analgesic. There are few circumstances in which emergency physicians have to provide the patient with a micro-relaxant.
This is essential when the tube can not pass through the trachea due to tension. As we have seen, induction is a procedure that all professionals who are in the emergency department should know how to carry out in the correct way to generate the least possible damage to the airways.
Likewise, it is important that they know the medicines they must supply in certain situations. Undoubtedly, we could consider the induction of rapid sequence an essential first aid measure.
Dr. Aditya Gupta is a highly accomplished Indian doctor with extensive experience in the field of neurology. Born and raised in New Delhi, India, Dr. Gupta completed his medical degree from the prestigious All India Institute of Medical Sciences (AIIMS), followed by his postgraduate studies in neurology from the same institution.
