On Wed, 15 Feb 1995, Tom Hesbach wrote:
> I am a paramedic and ACLS instructor and am unfamiliar with RSI - could
> you please send me information on RSI.
> Tom Hesbach, NREMT-P
RSI, Rapid Sequence Intubation is the technique of giving selected
paralytic, sedative, analgesic and/or other agents with rapid onset to
perform a controlled emergent intubation in an otherwise non-comatose
patient who still has a gag reflex. This is a very common technique used
to intubate children in impending respiratory failure, severe head
You don't have to fight to get the tube into place. It does carry risks
(so what doesn't?) including paralysis without the ability to secure an
advanced airway (practice your using BVM), increasing intracranial
pressure, and selecting a medication that may cause more harm than good
(e.g. succinylcholine in a burn patient).
Just as it is part of the armamentarium in the PED for airway management,
so should it be, so some of us think, that it should be available in the
prehospital care setting.
Of course, I posed the question to stimulate discussion, though it does
not appear to be as interesting a topic a conscious sedation. (A note to
those interested, the RVRBS Committee of the AAP Section on Emergency
Medicine has requested that the RUC establish a new CPT code for
I'll be happy to share more info on this subject with you if you'd like.
Jeff Linzer, MD, MICP
Prehospital Care Coordinator
Assistant Professor of Pediatrics
Emory University School of Medicine
phone: (404) 315-2747
fax: (404) 325-6233
[log in to unmask]