Steps in RSI
- Verbalise time out
- Ensure designation of roles – intubator, drug delivery, managing equipment, monitoring patient’s vital signs
- Check drugs, equipment
- Ensure plan discussed
- Give induction agent
- Give paralytic agent
- Wait 45-60 seconds after paralytic agent
- Pass endotracheal tube
- Move to plans B, C or D as needed
- Confirm end-tidal CO2, lung sounds, chest rise and misting of tube
The Difficult Airway Society, Intensive Care Society, FICM and the Royal College of Anaesthetists published a 2018 guideline on the management of tracheal intubations in critically ill adults.
As a minimum, the following personnel should be present during an intubation:
In the event of a failed or difficult airway, the following steps should be followed: