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Rapid sequence intubation guidelines 2021

Objective: Rapid sequence intubation (RSI) is a core critical care skill. Emergency medicine trainees are exposed to relatively low numbers of RSIs. We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence Rapid sequence induction and intubation (RSII) for anesthesia is a technique designed to minimize the chance of pulmonary aspiration in patients who are at higher than normal risk. The usual, nonrapid sequence of induction and intubation for anesthesia consists of administration of an induction agent, proof of the ability to mask ventilate.

Excerpt. Rapid sequence intubation (RSI) is a technique that is used when rapid control of the airway is needed as a precaution for patients that may have risks of pulmonary aspiration. This method is utilized by clinicians across multiple medical specialties, including critical care physicians, anesthesiologists, and emergency medical personnel Rapid Sequence Intubation: Medications, dosages, and recommendations !! ! Timeline'of'Rapid'Sequence'Intubation! S!!!!! 1. Preparation!-!Assemble!all. Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency. In emergency medicine, rapid sequence intubation (RSI) comes into play when there is neither the time nor the luxury of adequately prepping a patient whose airway and breathing are compromised. This article will not be a complete or exhaustive resource for this topic, but it can serve as a starting point for medical students

Safety of rapid sequence intubation in an emergency

  1. A, Failure to use the rapid sequence intubation checklist; and B, failure to use the video laryngoscope on the first attempt at laryngoscopy. Each dot represents the percentage of 10 patients. Missing data: 7 patients for the usage of the checklist and 10 patients for the video laryngoscope all in the operational period, and due to lack of an.
  2. DSI may be useful in patients for whom rapid sequence intubation would inevitably result in significant hypoxemia because they cannot tolerate preoxygenation by any other means, such as patients with agitated delirium from hypoxia, hypercapnia, or an underlying medical condition. July 2021 June 2021 May 2021 April 2021 March 2021 February.
  3. CPT Assistant (Dec. 2009) clarifies, Code 31500 should be reported for a stand-alone emergent or semi-emergent endotracheal intubation, such as rapid sequence intubation either using a rigid or flexible type of endoscope (ie, laryngoscope, bronchoscope).. There is no CPT® code for elective endotracheal intubation

Rapid sequence induction (RSI) is a method of achieving rapid control of the airway whilst minimising the risk of regurgitation and aspiration of gastric contents. Intravenous induction of anaesthesia, with the application of cricoid pressure, is swiftly followed by the placement of an endotracheal tube (ETT) Rapid sequence intubation (RSI) is an airway management technique that produces inducing immediate unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking agent) and is the fastest and most effective means of controlling the emergency airway. the cessation of spontaneous ventilation involves considerable risk if the. ATOTW 331 th- Rapid Sequence Induction (24 May 2016) Page 1 of 8 G E N E R A L Tutorial 331 Key Points • Rapid sequence induction (RSI) is intended to reduce the risk of aspiration by minimising the duration of an unprotected airway. • Preparation and planning - including technique, medications, team membe FILED DATE-APR 2 8 2021 THIS MATTER came before the Board of Nursing (Board) pursuant to Section 120.565, and rapid sequence induction in accordance with the Mayo Clinic's guidelines and to monitor the patient after the administration of the ketamine. Tano administered ketamine to a patient during rapid sequence intubation. 9. The Mayo. Thereby, it is possible to carry out intubation with stable hemodynamics after the 75 (30-105) seconds that are required for the onset of curarization 7 from the patient's last on command breath. The sequence described does not need the full hypnotic dosage needed for standard RSI, thus avoiding the consequent oversedation and hypotension

Rapid-sequence induction is advised to reduce the duration of the procedure and may be modified by ventilating the lungs before intubation when treating patients in whom even a brief period of. The rapid sequence intubation (RSI) is a technique developed to rapidly secure the airway, maximally reducing the time interval between the loss of the airway protective reflexes and the oro/nasotracheal intubation. Its importance lies in providing a safe intubation in patients at high risk of bronchoaspiration Rapid sequence induction and intubation (RSII) involves the simultaneous administration of an induction anesthetic and paralytic followed immediately by rapid intubation. This technique contrasts with standard induction, which allows for preoxygenation with mask ventilation in between administration of the induction anesthetic and intubation Rapid sequence intubation (RSI) is the standard of care in emergency airway management for intubations not anticipated to be difficult . RSI is the virtually simultaneous administration of a sedative and a neuromuscular blocking agent to render a patient rapidly unconscious and flaccid in order to facilitate emergency endotracheal intubation. These guidelines still do emphasize cricoid pressure. I disagree with that recommendation. They do recommend using nasal oxygen at 15 L/min for apneic oxygenation during the intubation procedure. Plan for failure. Failed intubation occurs in 10-30% of critically ill patients. It should be anticipated. Have a triggered transition to front of.

Rapid sequence induction and intubation (RSII) for

Tracheal Rapid Sequence Intubatio

Propofol and remifentanil for rapid sequence intubation in a pediatric patient at risk for aspiration with elevated intracranial pressure. Pediatr Emerg Care. Pediatr Emerg Care. 2013 ;29: 1201 - 1203 Rapid Sequence Induction Airway Checklist . Clinical Operating Guidelines Clinical Checklists Updated: 02.01.2021 (MD 20- 14) Page 1 of 1 Rapid Sequence Induction Airway Checklist . Reminder: Resuscitate then intubate - Risks HOp: Hypotension, Hypoxia, Hypoventilation (pH acidosis) 1st READY EQUIPMENT AND TEA Rapid sequence induction was mostly used for intubation. ROX index might be utilized for the predictor of the necessity of intubation in COVID-19 patients. According to the previous studies the rate of intubation reported 5 to 88%. It was revealed that 1.4 - 44.5% of patients might be extubated. Yet obesity and age (elderly) are the only risk.

Reaffirmed February 2018, April 2012, October 2006, October 2000. Originally approved September 1996 . Rapid-sequence intubation (RSI) is an important technique for airway management of patients in the emergency department and is in the domain of emergency medicine practice Rapid Sequence Intubation (RSI) 06/25/2015 Updated: 02/19/2021. Airway Management; Rapid Sequence Intubation. THE INFORMATION CONTAINED IN THIS DOCUMENT SHOULD BE USED FOR TRAINING ONLY. YOU MUST FOLLOW ALL OF YOUR LOCAL PROTOCOLS WHEN PERFORMING PATIENT CARE

Rapid sequence induction: where did the consensus go

Rapid Sequence Intubation: Basics for Medical Students EMR

Abstract: A rapid sequence induction (RSI) has been a routine part of the anesthetic management of patients with morbid obesity for over 40 years. A RSI consists of the rapid administration of a quick acting anesthetic induction agent and a paralytic in order to intubate the trachea as quickly as possible DEFINITION Rapid sequence intubation (RSI) is the virtually simultaneous administration of a sedative and a neuromuscular blocking (paralytic) agent to render a patient rapidly unconscious and flaccid in order to facilitate emergent endotracheal intubation and to minimize the risk of aspiration. 3 When increased intracranial pressure (ICP) is suspected, rapid sequence induction should be directed at minimizing the potentially adverse effects of intubation. In unusual cases of potential.

Southard A, Braude D, Crandall C. Rapid sequence airway vs. rapid sequence intubation in a simulated trauma airway by flight crew. Resuscitation . 2010;81(5):576—578. 25 Rapid Sequence Intubation with Remifentanil During COVID-19 Pandemic. Dear Editor, We greatly appreciate the interest that De Melo MS, et al. showed on the use of remifentanil in a rapid sequence intubation technique that we recently proposed for patients undergoing surgery during the current SARS-CoV-2 pandemic [1, 2]. The authors also reported the response that Tang and Wang wrote to comment. Condition at intubation, secondary outcomes and drugs used for 349 patients pre-oxygenated with high-flow nasal oxygen or facemask for rapid sequence induction of anaesthesia. Intubation adjuncts included use of Eschmann introducer, Macintosh #4 or video laryngoscope Respondents were asked about their preferences for rapid sequence intubation in patients with and without intestinal obstruction (Table 2). For a hypothetical patient with intestinal obstruction, there was a preference for, with OR (95%CI): the head-up or -down position 4.26 (3.98-4.55), p < 0.001; nasogastric tube insertion 29.5 (26.9-32.3.

Rapid sequence airway (RSA) is a modified form of rapid sequence intubation that uses an LMA inserted following induction (+/- administration of neuromuscular blockade) to maximise peri-intubation oxygenation prior to endotracheal tube insertion. Apneic oxygenation with nasal prongs or CPAP, and delayed sequence intubation (DSI) are alternative. Rapid Sequence Intubation Join our thousands of Resus members Subscribe for FREE regular updates in your inbox. Get notified on all upcoming Conferences PLUS our Webcasts, Education Newsletters, and more

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Sustained Improvement in the Performance of Rapid Sequence

  1. DAS / RCoA Teaching Material for the Novice Anaesthetist. Applications open on 26/02/2021 and close at midnight on 31/05/2021. We are delighted to announce that applications for the DAS Professor of Anaesthesia and Airway Management 2022 are now welcome! Awards will be presented at next DAS ASM. a) Education Lead b) Social Media Lead
  2. The impact of rapid sequence intubation on trauma patient mortality in attempted prehospital intubation. J Emerg Med. 2010 Feb. 38(2):175-81. . Davis DP, Dunford JV, Poste JC, Ochs M, Holbrook T, Fortlage D, et al. The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients
  3. Endotracheal intubation uses direct laryngoscopy to place an endotracheal tube into the trachea. The endotracheal intubation course uses advanced airway manikins to teach students how to position the head in the sniffing position for rapid sequence intubation. The intubation course will train students how to perform bag valve mask (BVM.
  4. The Scandinavian clinical practice guidelines on general anesthesia for emergency situations state that the combination of a hypnotic and an opioid must be used to reduce airway-related complications due to rapid-sequence induction. 4 Recently published guidelines for the management of tracheal intubation in critically ill adults recommend the.
  5. Rapid-onset paralytic agents are recommended to achieve muscle relaxation and facilitate tracheal intubation during rapid sequence induction in patients at risk of pulmonary aspiration of gastric contents. However, opioids are frequently used in this setting. The study's objective is to demonstrate the non-inferiority of remifentanil compared to rapid-onset paralytic agents, in association.
  6. Updated June 23, 2021 . 2 . Print Page Number Location Original Text Change When Change Was Made . for Treatment of Toxic Ingestions > Atropine > Adult Dose column 65 Bottom of page 65 > Rapid Sequence Intubation Protocol > row 4: Pharmacologic sedation/anesthesia/ne uromuscular blockade and protection/positioning 8. Apply cricoid pressure.
  7. e Versus Etomidate for Prehospital Rapid Sequence Intubation. Lucy Stanke, Steven Nakajima, Lisa Hall Zimmerman, Kevin Collopy, Carrie Fales, William Powers IV. July 2021. Volume 40, Issue 4 July-August, 2021; Volume 40, Issue 4 Access this journal on.

Working alongside emergency physicians and anesthesiologists, the clinical pharmacist developed a guideline for delivery of anesthetic medications in rapid sequence induction and intubation in trauma (Fig. 1) [].It was agreed that the default medication regimen for intubation would be two to three micrograms per kilogram of fentanyl, two milligrams per kilogram of ketamine and one milligram. Intubation in the ICU is a high-risk procedure ().Propofol, ketamine, and etomidate are common IV anesthetic agents used for induction of general anesthesia prior to rapid sequence intubation in critically ill patients ().The choice between them is variable, complex, and multifactorial and not always adapted to the clinical condition Rapid Sequence Intubation Protocol > row 4: Pharmacologic sedation/anesthesia/ne uromuscular blockade and protection/positioning 8. Apply cricoid pressure. {Delete 8. Apply cricoid pressure. and renumber the remaining items (11 numbered items total)} At next printing or update after 2/12/2021 66 Bottom of page 66 > Pharmacologic Agent Thanks Minh, as a footnote about the checklist above: best attempt first pass success intubation includes everything I think about like position of intubator (bed height) and position of patient ear-to-sternal notch, face-plane-parallel-to-ceiling positioning, jaw thrust, remove c-collar anteriorly with in line immobilization if applicable, head elevation, ELM/bimanual laryngoscopy, suction.

Rapid sequence intubation is an essential bullet in the maintenance of patency of the airway during intubation in emergency. It is a valid method in all th.. The term rapid sequence intubation is preferred over rapid sequence induction because the latter denotes the technique used by anesthesiologists for rapid airway control coincident with the initiation of anesthesia. The Anesthesiologist has many meds that can be given different routes for different types of surgeries that require rapid induction As such, the opinions and guidelines presented are those of the presenters. Any further questions regarding video should be directed to the webmaster by emailing: joshua.keckley@vanderbilt.edu or calling (615)936-3602 37. Stollings JL, Diedrich DA, Oyen LJ, et al. Rapid-sequence intubation: a review of the process and considerations when choosing medications. Ann Pharmacother. 2014;48(1):62-76. 38. Leeuwenburg T. Airway management of the critically ill patient: modifications of traditional rapid sequence induction and intubation. Crit Care Horizons. 2015;1:1.

Reynolds SF, Heffner J. Airway management of the critically ill patient: rapid-sequence intubation. Chest. 2005 Apr. 127(4):1397-412.. Bair AE, Filbin MR, Kulkarni RG, et al The optimal dose of succinylcholine for rapid sequence induction: a systematic review and meta-analysis of randomized trials. Source: PubMed (Add filter) Published by BMC anesthesiology, 02 March 2020. for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg- 1) remains unclear

BACKGROUND: The optimal order of drug administration (sedative first vs. neuromuscular blocking agent first) in rapid sequence intubation (RSI) is debated. OBJECTIVE: We sought to determine if RSI drug order was associated with the time elapsed from administration of the first RSI drug to the end of a successful first intubation attempt. METHODS: We conducted a planned secondary analysis of a. ‎Pharmacy to Dose: The Critical Care Podcast discusses critical care and its pharmacotherapy in a fun and entertaining manner. Each episode features a special guest, a subject matter expert, talking with host Nick Peters Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia. 2004;59(7):675-694. Hildreth AN, Mejia VA, Maxwell RA, Smith PW, Dart BW, Barker DE. Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. J Trauma. 2008;65(3):573-579 Version 4.23 1 May 4, 2021 Airway Management Guidelines for Patients with Known or Suspected COVID-19 Infection Emergency Medicine: George Kovacs (gkovacs@dal.ca) • Rapid sequence intubation should be used to facilitate first-pass intubation success and prevent patien Introduction: In 2010, Kinsella et al described the rapid sequence spinal (RSS) technique as an alternative to general anaesthesia (GA) for category 1 caesarean section (CS). 1 The practice of RSS has been reconsidered during the COVID-19 pandemic to avoid aerosol generating procedures, namely intubation or extubation, in a parturient who is COVID-19 positive. 2 In appropriate cases, RSS may.

patient is rapid sequence intubation (RSI). 1 Previous studies in the general population of patients under-going emergent intubation have shown that more than one attempt at intubation is associated with a substantial increase in the frequency of adverse events.2-4 The importance of obtaining intubation Intubation and extubation of ventilated patients are not risk-free procedures in the intensive care unit (ICU) and can be associated with morbidity and mortality. Intubation in the ICU is frequently required in emergency situations for patients with an unstable cardiovascular or respiratory system. Under these circumstances, it is a high-risk procedure with life-threatening complications (20.

Delayed Sequence Intubation: Basics for Residents EMR

Innovative educator Reuben Strayer, MD, has been promoting alternatives to rapid sequence intubation (RSI), specifically the use of ketamine assisted intubation in patients who have no margin for safe apnea. At SMACC, held in Chicago June 23-26, Dr. Weingart talked about the fact that RSI does not need to be first line in the critically ill. Version 2021.01.c. One of the crucial components of effective ACLS training is a familiarity with the major algorithms for different patient and/or provider scenarios. As a free resource for our visitors, this page contains links to sample algorithms for the main AHA Advanced Cardiac Life Support cases. See our website terms Hypoxia (most commonly recognised by low oxygen saturations) is a recognised complication of rapid sequence induction, and endotracheal intubation in general. High flow nasal oxygen (HFNO) application has the potential advantage over facemask pre-oxygenation of being continually administered during the apnoea period

26 November, 2020. 11 June, 2021. The 2020 Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) are a comprehensive revision of the AHA's guidelines for adult, pediatric, neonatal, resuscitation education science, and systems of care topics. They have been developed for. Davis DP et al. The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. J Trauma 2003; 54:444-453. Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Anesth Analg. 2004 Aug;99(2):607-13

Proper Coding for Endotracheal Intubation - AAPC Knowledge

Rapid sequence induction and intubation is the recommended technique for securing the airway in cases of full stomach. Management of aspiration depends on the nature of the aspirate. Pre-operative fasting guidelines have been established by various medical societies which may be modified in special circumstances of high risk of aspiration Editor—We read with interest the correspondence by Yao and colleagues 1 on emergency tracheal intubation in patients with coronavirus disease 2019 (COVID-19). We thank the authors for sharing their valuable experience in this constantly evolving crisis encompassing the globe, with guidelines on managing the disease being published daily

Effect of Intraoperative Low Tidal Volume vs Conventional

Rapid Sequence Induction : WFSA - Resource

The entire concept behind rapid sequence intubation is that the sedation lag time should be as short as possible. Ideally, the patient would go directly from breathing deeply (recruiting their lungs and clearing carbon dioxide) to a state of unconscious paralysis (blue curve below) Rapid sequence intubation (RSI) is an airway management technique that produces immediate anesthesia via an induction agent as well as rapid paralysis via a neuromuscular blocking agent. ↑ AHA 2015 guidelines comparison full text This page was last edited 13:54, 2 July 2021 by Brandon Simpson The patient's head of the bed was ramped up to 45 degrees. Utilizing rapid sequence intubation, the resident took one look with a size 4 Macintosh acquiring a Grade II view, and was able to place an 8-0 tube. A follow-up chest x-ray showed appropriate placement and frank pulmonary edema Rapid access (unscheduled) outpatient clinic: guidelines for referral. Rapid sequence induction of anaesthesia for intubation: checklist. Rapid sequence induction of anaesthesia for intubation: intubation drugs. Referral Criteria for Paediatric Continence Service. Referral Pathway for Paediatric Continence Service

Rapid Sequence Intubation (RSI) • LITFL • CCC Airwa

Rapid sequence induction and intubation (RSII) is a commonly chosen anesthetic technique for patients at risk of aspiration of gastric contents. Because of their associated clinical condition, some of these patients may have a nasogastric tube (NGT) placed preoperatively The types of intubation used were as follows: 129 (50.3%) sedative-only intubation, 110 (42.9%) rapid sequence intubation, 16 (6.3%) intubation without medication. The most common induction agent used was ketamine, and the only paralytic agent was succinylcholine (Table 2 ) Maternity Guidelines - Obstetric failed Intubation (GL774) May 2021 Fig. 1 The ramped position achieved by adjusting theatre table3 or use of Oxford HELP (Head Elevating Laryngoscopy Pillow)4 which is available in theatre 17 and 18. 6. Consider gentle facemask ventilation during rapid sequence induction (RSI) (ensure airway pressures ≤20 cm. Implementation of a Neonatal RSI Pre-sedation Protocol and Effect on First Attempt Endotracheal Intubation Attempts for Neonatal Transport Team Members PURPOSE In pediatric and adult transport environments, strong evidence demonstrates that Rapid Sequence Intubation (RSI) Protocols improve first attempt endotracheal intubation success rates In many places, paramedics perform intubation prior to hospital arrival. A total of 312 patients with severe TBI were randomly assigned to paramedic rapid sequence intubation or hospital intubation. ( Bernard et al 2011: 162) The success rate for paramedic intubation was 97%. At 6 months

Systematic Application of Rapid Sequence Intubation With

2. MD induce rapid sedation and paralysis 3. as soon as drugs are given, sellick procedure may be initiated 4. No BVM prior to ETT placement 5. Once the ETT is confirmed in place, cricoid pressure can be released 6. post intubation assessment of sedation and paralysis needs for mechanical ventilatio national guidelines, and probably due to safety concerns, rapid-onset paralytic agents are only used in 31 to 55% of rapid sequence induction [5-8]. When rapid-onset paralytic agents are not used for rapid sequence induction, opioids are frequently associ-ated with hypnotics during the intubation procedure Rapid sequence tracheal intubation (RSTI) is now the most widely used technique for tracheal intubation in the emergency department (ED) and cricoid pressure is taught as a standard component of emergency airway management (Ellis et al., 2007). Despite inadequate scientific evaluation of the risks and benefits of cricoid pressure it is adopted. The ability of paramedics to predict aspiration in patients undergoing prehospital rapid sequence intubation. J Emerg Med. 2006;30(2):131-6. Article PubMed Google Scholar 60. Bernard SA, Smith K, Porter R, Jones C, Gailey A, Cresswell B, et al. Paramedic rapid sequence intubation in patients with non-traumatic coma

Emergency Intubation in Covid-19 NEJ

Eighty-seven percent of intubations were performed by emergency physicians. In more than two-thirds of cases, rapid sequence intubation was utilized. The Skeptics Guide to Emergency Medicine (SGEM) is a knowledge translation project. Its goal is to cut the knowledge translation window down from an average of 10 years to one year Start studying Critical Care, Toxicology & Substance Abuse EXAM 1 Rapid Sequence Intubation, NMB, & Ventilation Stuff. Learn vocabulary, terms, and more with flashcards, games, and other study tools Rapid sequence intubation is the most common method of securing a definitive airway, and early blood product administration is associated with improved mortality. Military combat trauma guidelines, for this reason, recommend early blood product resuscitation. However, the relationship between these two tenets of trauma is not fully understood Quickly you review your approach to intubation including medications for rapid sequence intubation. Dr. research opportunity might be a meta-analysis of the multiple under-powered observational trials using the MOOSE guidelines to identify if the bulk of the evidence suggests a risk of harm with ©2021 Washington University in St. Louis. The aim of this prospective randomized study was to compare the performance of plastic and metal blades for orotracheal intubation during rapid sequence induction of anesthesia. Materials and Methods The study was approved by an ethics committee (Comité de Protection des Personnes se Prêtant à la Recherche Biomédicale Cochin-St Vincent de.

Rapid sequence intubation in the intensive care unit

Ninety percent recording compliance was required from each site for data inclusion. We included all patients > 14 years of age who received rocuronium for rapid sequence intubation from 1 Jan 2016 to 31 Dec 2018. We compared first-attempt success between encounters using alternative rocuronium doses (< 1.0, 1.0-1.1, 1.2-1.3 and ≥1.4 mg/kg) The evidence base for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg− 1) remains unclear. We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1.0 mg kg− 1) and reporting on intubating conditions and/or apnoea times Rapid Sequence Intubation is a crucial skill in the prehospital emergency setting in managing the ill and injured patient. It has its own risks but with sufficient training, competency, quality assurance and proper monitoring they can be minimized. There is not enough research published on RSI Caution: Rapid-sequence intubation in patients with blunt or penetrating neck injuries carries the risk of total loss of airway patency upon administration of sedative and/or muscle relaxant medication. Reduced conscious state; This can lead to hypoventilation and/or airway obstruction and hypoxia; Assess for airway stabilit

You are shortly about to perform a rapid sequence intubation . This is the RSI safety briefing for that procedure. Whilst you may have performed this procedure many times in the past, each one can be different so your attention to the briefing is greatly appreciate Related abbreviations. The list of abbreviations related to RSI - Rapid Sequence Intubation 迅速導入気管挿管 (Rapid sequence intubation: RSI) 10 years ago. Kohei Hasegawa. EMAのみなさま、. EMA教育班からお届けする、動画企画のパイロットバージョンです。. 今回は、救急医のABCのイの一番。