Classic Rapid Sequence Induction is considered fundamental to the provision of safe anesthesia according to Englehardt, 2014. Rapid Sequence Induction is an essential advanced airway technique used to reduce the possibility of pulmonary aspiration in high-risk patients. These high-risk patients can include pregnant patients, trauma patients, and other situations that are considered “full stomach” (Gencorelli, Fields, & Litman, 2010). Rapid Sequence Induction involves pre-oxygenation, administration of hypontics and muscle relaxants to allow for quick intubation (Eich et al., 2009). It involves the loss of consciousness during cricoid pressure followed by intubation without facemask ventilation (Sinclair & Luxton, 2005). The purpose of the
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The airway of a pediatric patient varies from the typical adult patient. A child’s head is proportionally larger than an adult’s head causing neck flexion and often airway obstruction while in the supine position (Gerardi et al., 1996). In addition, pediatric patients have a relatively large tongue, decreased muscle tone, a shorter, wider and softer epiglottis, a more anterior larynx, a shorter trachea, and a narrower airway with the cricoid ring being the narrowest part (Eckenhoff, 1951). In addition to these differences in their airway anatomy, pediatric patients have not fully matured and have decreased bone density. Due to these variances in both the anatomy and physiology of pediatric patients, applying the same procedure as performed on adult patients could have detrimental effects. Looking at modifications of the classical technique will help determine the best Rapid Sequence Induction plan for this unique patient …show more content…
An important characteristic of the ‘classic’ Rapid Sequence Induction technique is the elimination of bag mask ventilation compared to a traditional intubation. A marked difference between adults and pediatrics is the reduced apnea tolerance. This can be caused by insufficient preoxygenation, a reduced functional residual capacity, and increased oxygen demand (Reid, Chan, & Tweeddale, 2004). As a result, a modified practice involving the use of light, pressure-limited mask ventilation with 100% oxygen in the Rapid Sequence Induction of pediatric patients with pressures not exceeding 10-12 cm H2O aids with oxygenation, prevents hypercarbia keeping airways open, and minimizes gastric inflation (Schmidt, Strauss, Becke, Giest, & Schmitz, 2007). Currently, there is a large amount of research, literature, and information about Rapid Sequence Induction with adult patients. It has been accepted that the Rapid Sequence Induction technique is performed by giving a hypnotic agent (i.e. propofol), followed by a fast-acting muscle relaxant (i.e. succinylcholine) in rapid succession while cricoid pressure is given to prevent regurgitation of gastric contents (Gencorelli, Fields, & Litman, 2010). This may not be optimal in the pediatric patient, as previously
The airway of a pediatric patient varies from the typical adult patient. A child’s head is proportionally larger than an adult’s head causing neck flexion and often airway obstruction while in the supine position (Gerardi et al., 1996). In addition, pediatric patients have a relatively large tongue, decreased muscle tone, a shorter, wider and softer epiglottis, a more anterior larynx, a shorter trachea, and a narrower airway with the cricoid ring being the narrowest part (Eckenhoff, 1951). In addition to these differences in their airway anatomy, pediatric patients have not fully matured and have decreased bone density. Due to these variances in both the anatomy and physiology of pediatric patients, applying the same procedure as performed on adult patients could have detrimental effects. Looking at modifications of the classical technique will help determine the best Rapid Sequence Induction plan for this unique patient …show more content…
An important characteristic of the ‘classic’ Rapid Sequence Induction technique is the elimination of bag mask ventilation compared to a traditional intubation. A marked difference between adults and pediatrics is the reduced apnea tolerance. This can be caused by insufficient preoxygenation, a reduced functional residual capacity, and increased oxygen demand (Reid, Chan, & Tweeddale, 2004). As a result, a modified practice involving the use of light, pressure-limited mask ventilation with 100% oxygen in the Rapid Sequence Induction of pediatric patients with pressures not exceeding 10-12 cm H2O aids with oxygenation, prevents hypercarbia keeping airways open, and minimizes gastric inflation (Schmidt, Strauss, Becke, Giest, & Schmitz, 2007). Currently, there is a large amount of research, literature, and information about Rapid Sequence Induction with adult patients. It has been accepted that the Rapid Sequence Induction technique is performed by giving a hypnotic agent (i.e. propofol), followed by a fast-acting muscle relaxant (i.e. succinylcholine) in rapid succession while cricoid pressure is given to prevent regurgitation of gastric contents (Gencorelli, Fields, & Litman, 2010). This may not be optimal in the pediatric patient, as previously