In my Prehospital RSI Checklist, under “Procedure” you will see a “Time-Out” called. This is designed as a last minute check before the procedure is initiated. Is the Intubator and their selected equipment ready? Are all meds drawn up and proper dosages confirmed? Does Assistant(s) understand their roles and responsibilities? Is all needed equipment selected and within arm’s reach? Are there any contraindications to succinylcholine if being used (e.g. med alert tags for malignant hyperthermia, evidence of hyperkalemia, peaked T waves, evidence or hx of muscle wasting disease)?.
- Heart Rate
- Blood Pressure
- Blood Sugar
- Acidosis (Salicylates, DKA) If RSI is necessary, maintain patients ventilatory rate
- Check for Medical Alert ID’s
- Anticipated problems: Any questions or concerns?
- Is patient positioned optimized?
If all clear….push meds and allow approx. 30-45 seconds for the patient to become flaccid. Monitor O2 sat, HR – Provide a tight seal of the BVM (only bag during apneic oxygenation if O2 sat <93%). If ventilating is required, ventilate slow with low volume. In addition ALWAYS maintain HF NC at 15L. RSI Checklist v2.6