RSI planning involves considering 7 key areas - Predicted difficulty, Place, Positioning, Pre/peri-oxygenation, Paralysis and induction drugs, Post intubation confirmation, and Post intubation plan. The key equipment needed includes suction, oxygen sources, airways, procedure equipment, monitoring, and extras. Prior to beginning, the team should introduce themselves, plan for Plan A intubation, Plan B if needed such as repositioning or alternative devices/operators, and Plan C such as a surgical airway. Roles should be assigned and any questions addressed.

1. RSI Planning (7 Ps)
PREDICTED DIFFICULTY PLACE POSITIONING PRE/PERI- PARALYSIS AND POST INTUBATION POST INTUBATION
OXYGENATION INDUCTION DRUGS CONFIRMATION PLAN
Consider · EAM to sternal
L – Look notch. · Sitting · Induction drug and · Stethoscope V – Ventilation and
· Weather dose circuit
E – Evaluate (3:3:2) ·Sitting/Ramped/r · OP/NPA considered · Waveform
· Light conditions eversetrendelenbu · Paralytic drug and Capnography S – Sedation
M – Mallampati optimal. rg · Hudson mask or dose (preferred)
BVM (15L/min) (SuxmethoniumvsRo A – Analgesia
O – Obstructive signs · 360° access to pt ·Stretcher height curonium) ·QuantativeCapno
optimal (ideally · Consider PEEP valve P – Paralysis
N – Neck Immobility metry
· Proximity to with BVM
kneeling/standing, · Co-induction agents
ambulance or P – Procedures?
C – Cricothyroid not on the floor) (Opioid, ·Easycap
helicopter · Nasal prongs (Thoracostomyetc)
membrane palpable, benzodiazepine)
15L/min (PreO2 and
consider marking Apneoic oxygenation) · Other drugs (fluids,
Difficultypredicted-> call vasoactive
· Delayed Sequence
for help &chronotropic
intubation using NIV
drugs)
·2 minutes, SpO2
·
>98% +/- ETO2 >80%.
Equipment
Brief
S – Suction working (Consider two sources if diffuse bleeding/debris)
Introduce team
O – Oxygen sources (Ideally two) Plan A
A – Airways (OPA and two NPAs) Plan B (Repositioning, cricoid off, suctioning, ELM,
alternative laryngoscope/operator, LMA)
P – Procedure Equipment (Laryngosopes/Bougie/ETT/Syringe/BVM/HMEF/Ties) Plan C - CICV and CICO (Cricothyroidotomy or
Surgical airway)
M – Monitoring (ECG/NiBP/SpO2/ETCO2) and 2x IVC (Consider IO)
Roles (Drugs, MILS, Cricoid, Laryngoscopist)
E – Extras (Video laryngoscope, LMA/iLMA, cricothyroidotomy equipment, Surgical Any Questions or Concerns prior to proceeding?
airway kit).