Rapid Sequence Intubation

(RSI)
dr. Shinta Pratiwi, M.Ked.Klin., Sp.An.

PELATIHAN ASUHAN KEPERAWATAN DASAR ANESTESI

MARET 2021
Rapid Sequence Intubation
 Tujuan : to minimize time between loss of upper
airway protective reflex and definitive airway
Indikasi : pasien resiko regurgitasi & aspirasi

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 Preparation

7P Post Intubation
Management
Preoxygenation

Placement of Tube Pretreatment

Paralysis w/
Positioning
induction

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Preparation
Assess Predicted Difficult Airway
Monitoring
Emergency Drugs
ETT & Laryngoscope
IV Access

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Preoxygenation
Tujuan : Denitrogenisasi FRC
Avoid Positive Ventilation
How
8x Deep Breath in 60 secs
O2 nasal canula 15 lpm in 15 min

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Pretreatment
Medications given 3 minutes before the paralysis stage
with the aim of protecting the patient from the
adverse effects of introducing the laryngoscope and
endotracheal tube
Lidocaine : 1,5 mg /kg  supress cough reflex in
suspected increased ICP
Atropine : 0.01-0.02 mg/kg  prevent bradycardia in
pediatric

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Paralysis with Induction
Traditional RSI : Succinylcholine 1-2 mg/kgBB
Recommended non-depol NMB
Rocuronium 1.2 mg/kg  achieved in 30 sec

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Positioning
Align axis of Mouth, Pharynx & Larynx  Sniffing
position
Sellick Maneuver  Occlude Esophagus  Prevent
Aspiration

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Placement of Tube
Laryngoscopy  intubation

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Post Intubation Management
Confirmation of proper tube placement by etCO2 &
auscultation

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Timeline:

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