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Rapid sequence induction
Rapid sequence induction, also described as rapid sequence intubation (RSI), is an advanced airway management medical procedure used to achieve tracheal intubation under general anesthesia in patients who are at high risk of pulmonary aspiration. RSI involves pre-filling the patient's lungs with a high concentration of oxygen gas, followed by administering rapid-onset hypnotic and neuromuscular-blocking drugs that induce prompt unconsciousness and paralysis, allowing tracheal intubation with minimal delay. Unlike other methods of induction, no artificial ventilation is provided from the time that drugs are administered until after intubation has been achieved; this minimises insufflation of air into the stomach, which might otherwise lead to regurgitation.
The procedure is used where general anesthesia must be induced before the patient has had time to fast long enough to empty the stomach; where the patient has a medical condition that makes aspiration more likely during induction of anesthesia, regardless of how long they have fasted (such as gastroesophageal reflux disease); or where the patient has become unable to control their own airway even before anesthesia (such as after a traumatic brain injury).
The induction drugs preferentially used in RSI have short durations of action, wearing off after only minutes. This confers a degree of fault tolerance on the procedure when it is used in elective or semi-elective settings: if intubation is unsuccessful, and if the clinical condition allows it, the procedure may be abandoned and the patient should regain the ability to protect their own airway sooner than would be the case under routine methods of induction. Conversely, in emergency settings where the patient's condition does not allow for them to be woken up immediately, a failed RSI places them at very high risk for respiratory compromise.
== Common medications ==
Commonly used medications during a rapid sequence intubation:
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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