MCQ – 92897

Which statement in rapid sequence intubation is incorrect?

Correct Answer » C Explanation

• Rapid Sequence Intubation (RSI) is an airway management technique designed to rapidly secure the airway while minimizing the risk of aspiration.
• It is commonly used in patients with:
  • Full stomach
  • Trauma
  • Altered sensorium
  • Intestinal obstruction
  • Emergency surgery

Explanation of the Correct Answer

• RSI is not the first-choice airway management technique in cardiac arrest.
• During cardiac arrest:
  • High-quality chest compressions and early defibrillation (when indicated) take priority.
  • Initial airway management is usually performed with bag-mask ventilation or a supraglottic airway device.
  • Endotracheal intubation is performed only if it can be achieved without prolonged interruption of chest compressions.
• Therefore, the statement is incorrect.

Why Other Options are Correct

A. Preoxygenation with 100% oxygen for 3 minutes is performed before induction.

• Correct.
• Preoxygenation replaces nitrogen in the lungs with oxygen, increasing oxygen reserves and prolonging the safe apnea period.
• It is typically performed using 100% oxygen for 3 minutes or by administering 8 deep vital-capacity breaths over 60 seconds.

B. A high-volume, low-pressure cuffed endotracheal tube is used.

• Correct.
• Modern cuffed endotracheal tubes are high-volume, low-pressure cuffs.
• They:
  • Minimize tracheal mucosal injury.
  • Provide an effective seal.
  • Reduce the risk of aspiration.

D. The induction agent and the neuromuscular blocking agent are administered in rapid succession (virtually simultaneously).

• Correct.
• RSI involves rapid administration of:
  • An induction agent (e.g., propofol, etomidate, ketamine).
  • Followed immediately by a neuromuscular blocker (e.g., succinylcholine or rocuronium).
• The goal is to achieve rapid unconsciousness and paralysis for prompt intubation.