RSI PROTOCOL

By: Dr. Robert Simonson

The Medical Advisory Committee (MAC) has been responsible for writing many pre-hospital protocols -- or to be more correct -- "suggestions" from which EMS medical directors may use to write their own protocols.

With this comes a certain amount of "accountability" which this committee must bear. We try our best to be current and accurate with regards to medical information.

A certain amount of controversy always enters the picture and this is no more apparent than that which exists over RSI (rapid sequence intubation).

RSI has been around for years in the Emergency Department but its existence in pre-hospital circles is relatively new. There exists no reliable study to date, which validates that this skill has saved any lives. As a full time practicing Emergency Medicine Physician, I have been too busy to "submit" any data regarding whether this skill saves lives in it, but I think it has. RSI is not for every medic in the field. One’s simple airway skills (BMV, intubation) must be good and there MUST be ongoing quality assurance benchmarks in place for feedback. There should be a minimum number of such intubations per set time, or one should go to the ER or for review and observed practice.

If the Medical Director thinks this procedure has a place in his system, then he must be an active participant in its implementation and daily use.

The RSI protocol found on this page is simple to use and easily mastered (at least the paper work part of it).

Your Medical Director may decide to change some of the drugs, or doses but what is submitted is time proven to be safe and effective. Should you have any comments or questions, feel free to contact me.