Table 1

Rapid sequence induction procedure

1Preoxygenate with 100% oxygen
2Monitor pulse, BP, ECG and oxygen saturation
3Establish intravenous access
4Loosen cervical collar and maintain in-line cervical immobilistaion from below
5Give IV bolus etomidate (0.3 mg/kg)
6Give IV bolus suxamethonium (1–1.5 mg/kg)
7Apply cricoid pressure at the time of injection of induction agent
8Once muscle fasciculations have stopped, perform laryngoscopy and intubate using predetermined sized endotracheal tube cut to appropriate length
9Verify tube postion by auscultation over both sides of the chest and over the stomach and with attached end tidal CO2 monitoring
10Remove cricoid pressure and replace cervical collar
11Secure endotracheal tube
12Administer pancuronium (0.1 mg/kg) to maintain paralysis for transport
13Administer propofol (1–2 mg/kg), midazolam (0.1–0.4 mg/kg) or morphine (0.1 mg/kg) for sedation