Airway management is a core lifesaving skill for any health care worker.In emergency and certain special preoperative cases for general anaesthesia,rapid sequence induction is performed for endotracheal intubation as a ‘standard of care’…
Download file to see previous pages...
In emergency and certain special preoperative cases for general anaesthesia, rapid sequence induction (RSI) is performed for endotracheal intubation as a ‘standard of care’. Emergency care staff should be well versed with this technique of airway management. Neuromuscular blockers (NMBs) are a group of drugs which are used for intubation. They play an important role in endotracheal intubation. Depending upon their mechanism of action, these drugs can be classified into depolarizing and non-depolarising agents. This essay will discuss aims, indications, technique and dugs, and complications of RSI. Separately, this essay will also focus upon the actions of depolarizing and non-depolarizing neuromuscular blockers. Rapid Sequence Induction Aims The aims of rapid sequence induction are to secure the airway as soon as the airway reflexes are lost, optimise oxygenation and ventilation, prevent contamination of the airways and lungs by aspiration of regurgitated oesophageal or stomach contents, or blood and prevent the complications of aspiration such as aspiration pneumonitis, hypoxemia and/or death (Sinclair & Luxton, 2005). Indications Rapid sequence induction is indicated in situations and patients where airway protection is immediately required and there is a danger of aspiration of regurgitated gastrointestinal contents and blood in the airway. It is performed in the operation theatre under controlled conditions, whereas in pre hospital setup, it is performed with limited resources and expertise (Sinclair & Luxton, 2005). It is performed in patients requiring intubation who are assumed to be ‘full stomach’ (non-fasting) and have a high risk of aspiration such as patients with traumatic brain or bodily injury and loss of consciousness, pregnant patients, patients with raised intra-abdominal pressure (ascites, obesity, chronic renal failure), head and neck injury and bleeding into the oral cavity or airway (Perry, Lee, Silberg & Wells, 2008; Bernard et al, 2009). Complications RSI can be associated with the following complications: 1. Failure to secure the airway and resultant hypoxemia, and organ damage or death (Sinclair & Luxton, 2005) 2. Interruption of chest compressions during cardiopulmonary resuscitation. 3. Unrecognised oesophageal or maintsem bronchial intubation 4. Complications due to under-dosing or over-dosing of drugs such as awareness, hypotension, hyperkalaemia, arrhythmias and cardiac arrest 5. Injury to oral and laryngeal structures 6. Raised intracranial and intraocular pressure and stress responses associated with laryngoscopy and intubation such as tachycardia, hypertension and bronchospasm (Sinclair & Luxton, 2005). Technique, drugs and dosages The opinions regarding the drugs, their dosages and their method of administration in RSI are changing (El-Orbany & Connolly, 2010). Conventionally, RSI has involved the components of preoxygenation, rapid administration of induction agents and muscle relaxants, cricoid pressure application (Sellick’s manoeuvre), endotracheal intubation and cuff inflation, and non-application of bag-mask or positive pressure ventilation (Bernard, 2006). A pre-calculated dose of induction agent is given followed by fast acting muscle relaxant and as the patient starts to lose consciousness, cricoid pressure is applied. After 45 seconds to one minute, laryngoscopy is done, patient is intubated and the cuff of endotracheal tube (ET) is inflated. Only after confirmation of endotracheal placement of the tube with EtCO2 and
...Download file to see next pagesRead More
This paper is going to focus on Rapid Sequence Induction and Intubation (RSII) a situation I came across during my placement. I will give a reflection of this incident as was performed on an obese patient during my clinical placement.
In order to understand the characteristics of induction, an experiment set out to investigate the operation of electromagnetic induction. The prime aim of this experiment was to investigate the magnets and coils behaviour, to test Lenz’s law and Faraday’s law, and to test the transformers behaviour.
The benefits of anaesthesia in terms of pain relief need to be balanced against the procedural risks which also to a larger extent depend upon factors such as anaesthetic agent used, pre-existing illness, age and constitution of the person. Physician’s assistants and nurses are usually involved when anaesthetic is underway under the guidance of anaesthetists and the anaesthetists direct intervention is required at the time of administration and at the end.
PR World was a very small setup with independent group ownership. First Choice is able to offer a greater discount to its customers because of its higher turnover and transaction rate. The number of customers using First Choice will be more than the others.
As the bleeding causes obstruction of airway passage, tubulation is indicated.
Rapid Sequence Intubation (RSI) is a commonly used technique for managing airway emergencies. The technique involves tabulating the patient along with the use of anaesthetics, muscle relaxants and paralytic agents.
In all set inductions, there are some sets that are usually used just before any new activity is introduced to students.
An effective set should have a level of clarity so that students are aware of what to expect from a
Among the applications of dynamic programming in computational biology include assembling DNA sequence data from automated sequencing machines, determining the intron or exon structure in eukaryotic genes and also
Mannitol is considered an osmotic diuretic agent and also a renal vasodilator. It is applied clinically for osmotherapy in order to decrease intracranial pressure until other treatment options can be applied (Battison, Andrews, Graham, and Perry, 2005). It
Two, genetically modified agent hazards-this is the possibility that the genetic modification could increase an agent’s pathogenicity or affect its susceptibility to antibiotics or any other effective treatments. Three, hazardous characteristics of laboratory procedures, this is important as it helps to know to what extent a particular pathogen can cause risk.
2 Pages(500 words)Essay
GOT A TRICKY QUESTION? RECEIVE AN ANSWER FROM STUDENTS LIKE YOU!
Let us find you another Essay on topic Rapid Sequence Induction Neuromuscular Blocking Agents for FREE!