rapid sequence induction
Last reviewed 01/2018
Rapid sequence induction describes the quick but controlled advance from induction to maintenance in patients with a high risk of vomiting or regurgitation, e.g. in non-fasted patients, those with hiatus hernia, those with gastrointestinal disturbance and in pregnant females.
The steps are:
- give the conscious patient a 100% oxygen mixture for 3-4 minutes before induction; this provides as much time as possible for intubation by replacing 21% oxygen in the lung with 100%
- begin to apply intravenous induction agent
- apply cricoid pressure - the Sellick manoeuvre
- give a short-acting muscle relaxant intravenously
- intubate the patient with an endotracheal tube, ensure its position and inflate to prevent regurgitation
- release cricoid pressure
- start volatile agent anaesthetic with oxygen