Editing Rapid sequence induction (section)

== History ==
First described by William Stept and [[Peter Safar]] in 1970, "classical" or "traditional" RSI involves pre-filling the patient's lungs with a high concentration of [[oxygen]] gas; applying [[cricoid pressure]] to occlude the [[esophagus]]; administering pre-determined doses of rapid-[[onset of action|onset]] [[sedative]] and [[neuromuscular-blocking drug]]s (traditionally [[thiopentone]] and [[Suxamethonium chloride|succinylcholine]]) that induce prompt [[unconsciousness]] and [[paralysis]]; avoiding any artificial positive-pressure [[Ventilation (physiology)|ventilation]] by mask after the patient stops breathing (to minimize insufflation of air into the stomach, which might otherwise provoke [[regurgitation (digestion)|regurgitation]]); inserting a cuffed [[endotracheal tube]] with minimal delay; and then releasing the cricoid pressure after the cuff is inflated, with ventilation being started through the tube.<ref name="pmid13749923">{{cite journal | vauthors = Sellick BA | title = Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia | journal = Lancet | volume = 2 | issue = 7199 | pages = 404–406 | date = August 1961 | pmid = 13749923 | doi = 10.1016/s0140-6736(61)92485-0 }}</ref><ref name="pmid5534675">{{cite journal | vauthors = Stept WJ, Safar P | title = Rapid induction-intubation for prevention of gastric-content aspiration | journal = Anesthesia and Analgesia | volume = 49 | issue = 4 | pages = 633–636 | year = 1970 | pmid = 5534675 | doi = 10.1213/00000539-197007000-00027 | s2cid = 11716695 | doi-access = free }}</ref><ref name="pmid26917599">{{cite journal | vauthors = Sajayan A, Wicker J, Ungureanu N, Mendonca C, Kimani PK | title = Current practice of rapid sequence induction of anaesthesia in the UK - a national survey | journal = British Journal of Anaesthesia | volume = 117 | pages = i69–i74 | date = September 2016 | issue = Suppl 1 | pmid = 26917599 | doi = 10.1093/bja/aew017 | doi-access = free }}</ref> There is no consensus around the precise definition of the term "modified RSI", but it is used to refer to various modifications that deviate from the classic sequence – usually to improve the patient's physiological stability during the procedure, at the expense of theoretically increasing the risk of regurgitation.<ref name="ceaccp2014" /> Examples of such modifications include using various alternative drugs, omitting the cricoid pressure, or applying ventilation before the tube has been secured.<ref name="ceaccp2014" />