Save a Life: Know the Precious P’s of Rapid Sequence Intubation

Photo: Wikimedia Commons

Author: Valery Victoria Rivas Cuesta, MSVI
Medical Student
Universidad Iberoamericana (UNIBE) School of Medicine

An emergency physician’s failure to secure the airway can rapidly lead to death or disability. In the emergency setting, patients are assumed to have a full stomach and be at risk for aspiration. Often, rapid-sequence intubation (RSI) represents the preferred method to secure the airway in the ED setting, as it results in unconsciousness (induction) and neuromuscular blockade (paralysis) rapidly thereafter.[1]

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The procedure has the following main goals: prevention of hypoxia, shortening the time between induction and intubation, minimizing aspiration risk, and improving first pass success.[1] This is achieved by the “ritual of the P’s”:[2]

Resident Journal Review: An Update on Airway Management in Emergency Medicine

Originally Published: Common Sense, Nov/Dec 2012

Original Authors: Authors: Michael Allison, MD; Michael Scott, MD; Kami Hu, MD; David Bostick, MD; Daniel Boutsikaris, MD

Edited by: Michael C. Bond, MD FAAEM; Jay Khapde, MD FAAEM

 There are few clinical skills as important to the emergency physician as emergency airway management. The field of airway management is constantly changing, and the practicing physician must keep abreast of the current trends in laryngoscopy, medication management, prehospital intubation, and the potential complications of intubation. Reviewed here are some of the key airway-related articles published over the past two years.

Direct Laryngoscopy Compared to Video Laryngoscopy