Resuscitative Sequence Intubation

There are 4 main physiological areas, we need to target, as they can result in peri-intubation cardiac arrest.

Hypotension

Positive pressure ventilation secondary to intubation, increases intrathoracic pressure which increases right atrial pressure resulting in decreased pressure differential and less blood coming back into the heart.

What may help

• Volume resuscitation may increase cardiac output
• If patients are not fluid responsive, vasopressors may be used: Noradrenaline is the drug of choice.
• Adrenaline 10-50mcg boluses can be used as needed for BP
•  Metaraminol can be used: Increases peripheral vascular resistance, Increases force of myocardial contraction.......

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