Avery Pascale, Morton Sarah, Raitt James, Lossius Hans Morten, Lockey David
Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK.
Essex & Herts Air Ambulance, Flight House, Earls Colne, Colchester, Essex, CO6 2NS, UK.
Scand J Trauma Resusc Emerg Med. 2021 May 13;29(1):64. doi: 10.1186/s13049-021-00883-5.
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 anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI - training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment.
The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles - rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged.
快速顺序诱导（RSI）被引入以尽量减少紧急气管插管期间胃内容物误吸的风险。它包括使用硫喷妥钠和琥珀胆碱诱导，并应用环状软骨压迫法。这篇叙述性综述描述了在英国和其他地方传统RSI是如何被改进的，旨在在手术室以外的环境中提供安全有效的紧急麻醉。自从首次描述该操作以来，传统RSI的大多数关键方面——培训、技术、药物和设备都受到了挑战，并且经常发生显著变化。已经进行了一些改变，以提高干预的安全性和质量，同时保留快速建立确定性气道和避免胃内容物误吸的原则。RSI不再仅由麻醉医生完成，并且可以在包括院前环境在内的各种环境中安全实施。
当前紧急情况下RSI的实施与该操作最初的描述有很大不同。尽管如此，快速建立确定性气道和避免误吸的原则仍然高度相关，并且RSI的适应症相对保持不变。
