Raigmore Critical Care Guidelines Rapid Sequence Induction in

Raigmore Critical Care Guidelines Rapid Sequence Induction in Critical Care Aim To provide a checklist for induction of anaesthesia in the critically unwell child. Scope All paediatric patients requiring rapid sequence induction Paediatric Rapid Sequence Induction Checklist Team Roles Doctor 1: Airway Doctor 2: Drugs Nurse 1. Assistant (at airway trolley) Nurse 2. Cricoid Pressure (line of sight to monitor ) Nurse 3. Manual in line control (if required) Equipment Suction: working, Yankeur under right side of pillow Ambu bag: 15 l/min O 2, PEEP valve (or alternative circuit as directed) ETT: correct size, cut appropriately, cuff checked & lubricated ETT: one size smaller in packet on trolley top Two working laryngoscopes with blades 10 ml syringe (if ETT cuffed) Tube tape cut in “trouser legs” Gum Elastic Bougie on trolley top Oropharyngeal airway on trolley top Capnography set up and function confirmed Stethoscope Ventilator checks complete Alternative O 2 source Appropriate LMA, 50 ml syringe and surgical airway kit available Drugs Demonstrate iv/io access patent and accessible Hypnotic agent: identify syringe, confirm drug, dose and volume to be injected Opiate: identify syringe, confirm drug, dose and volume to be injected Muscle relaxant identify syringe, confirm drug, dose and volume to be injected Atropine: identify syringe, confirm drug, dose and heart rate decision point Sedative infusions: confirm drug and starting infusion rates Briefing Verbally rehearse failed airway plan Adapted from checklist by Richard Price EMRS M Mac. Kinnon 22. 11. 2016