The key difference between rapid sequence intubation and normal intubation is that rapid sequence intubation can be induced with a full stomach, while normal intubation can be induced only with an empty stomach.
Intubation is a clinical procedure implemented to remove air blockages, especially during breathing difficulties. It moves air in and out of the lungs when a patient is unable to conduct the normal respiration process. Rapid sequence intubation and normal intubation are two types of intubations commonly used by medical practitioners.
CONTENTS
1. Overview and Key Difference
2. What is Rapid Sequence Intubation
3. What is Normal Intubation
4. Similarities – Rapid Sequence Intubation and Normal Intubation
5. Rapid Sequence Intubation vs Normal Intubation in Tabular Form
6. Summary – Rapid Sequence Intubation vs Normal Intubation
What is Rapid Sequence Intubation?
Rapid sequence intubation (RSI) is an airway management technique that involves the administration of an inducing agent and a neuromuscular blocking agent and is performed on a full stomach. The inducing agent induces immediate unresponsiveness, and the neuromuscular blocking agent induces muscular relaxation. RSI is the most effective and fastest way of controlling the emergency airway. During the end of spontaneous ventilation, there is a significant risk if the provider fails to intubate or ventilate the patient at the appropriate time.
Rapid sequence intubation is important for patients with an intact pharyngeal reflex and a life-threatening injury or illness that requires immediate airway control. There are several roles during RSI. They are airway proceduralists, airway assistants, and drug administrators. Indications such as airway protection and patency, respiratory failures, sepsis situations, temperature controls, unresponsive to pain, and humanitarian reasons require RSI.
What is Normal Intubation?
Normal intubation is a technique where healthcare providers insert tubes through the patient’s mouth or nose down the trachea or airway passage. It is done with an empty stomach. Intubation is important during a situation when the airway is blocked or damaged. Therefore, this tube keeps the airway passage open for air to pass through. The procedure of intubation includes insertion of an IV needle into the arm, delivery of medication through IV for anesthesia, placing an oxygen mask for extra oxygen, insertion of a laryngoscope into the mouth, raising the epiglottis, inflating a small balloon around the endotracheal tube to give air through the tube until it reaches the lungs, removing the laryngoscope, and testing to make sure the tube is placed right by taking an X-ray.
Common conditions that lead to intubation are airway obstruction, cardiac arrest, injury or trauma to the neck, chest or abdomen, which affects the airway, loss of consciousness that leads to a loss of control in the airway, respiratory failure or apnea, and risk of aspiration. However, there are certain risks of intubation. These include aspiration, where the patient may inhale vomit, blood, or other fluids; endobronchial intubation; esophageal intubation; failure to secure the airway; infections, injury, or problems due to anesthesia; and tension pneumothorax.
What are the Similarities Between Rapid Sequence Intubation and Normal Intubation?
- RSI and normal intubation are airway management techniques.
- Before starting these procedures, it is necessary to check all patient parameters such as EKG, NIBP, Oximitry, and End-tidal CO2/CO2.
- Both types require checking whether the stomach is full or not.
- Both types require assessing the type of air blockage before treatment.
What is the Difference Between Rapid Sequence Intubation and Normal Intubation?
Rapid sequence intubation can be induced with a full stomach, while normal intubation can be induced only with an empty stomach. Thus, this is the key difference between rapid sequence intubation and normal intubation. During rapid sequence intubation, the patient should not be masked, while, in normal intubation, the patient can use bag-mask ventilation. Furthermore, rapid sequence intubation is used during emergency situations, while normal intubation is used during non-emergency situations.
The below infographic presents the differences between rapid sequence intubation and normal intubation in tabular form for side-by-side comparison.
Summary – Rapid Sequence Intubation vs Normal Intubation
Air blocks are common occurrences during breathing abnormalities. Rapid sequence intubation and normal intubation are two techniques used to remove such air blocks. Rapid sequence intubation can be induced with a full stomach, while normal intubation can be induced only with an empty stomach. Rapid sequence intubation (RSI) is a technique that uses an inducing agent and a neuromuscular blocking agent. Normal intubation is a technique where tubes are inserted through the patient’s mouth or nose down the trachea or airway passage. Moreover, in rapid sequence intubation, the patient should not be masked, while in normal intubation, the patient can use bag-mask ventilation. So, this summarizes the difference between rapid sequence intubation and normal intubation.
Reference:
1. “Intubation: Purpose, Procedure and Potential Risks.” Cleveland Clinic.
2. Nickson, Chris. “Rapid Sequence Intubation (RSI).” Life in the Fast Lane • LITFL.
Image Courtesy:
1. “Glidescope 02” By Own work by DiverDave (talk) (Transfered by PhilippN/Original uploaded by DiverDave) – (Original uploaded on en.Wikipedia) (CC BY 3.0) via Commons Wikimedia