Data viva — the classical versus the modified rapid sequence induction

Stimulus

A two-column timeline comparing the two techniques. The left column shows the seven-step classical RSI as numbered panels: 1 Preoxygenation (100 per cent oxygen for three minutes or eight vital-capacity breaths), 2 Pre-treatment (optional opioid), 3 Induction (thiopental or propofol or ketamine), 4 Paralysis (suxamethonium 1 to 1.5 mg per kg or rocuronium 1.2 mg per kg), 5 No mask ventilation with cricoid pressure applied before loss of consciousness, 6 Intubation at 45 to 60 seconds, 7 Confirmation by waveform capnography then release of cricoid pressure. The right column overlays the five modifications that define the modern RSI: gentle mask ventilation during the apnoeic period, reduced or omitted cricoid pressure, THRIVE high-flow nasal apnoeic oxygenation at 70 L per min, video laryngoscopy as first-line, and rocuronium 1.2 mg per kg with sugammadex 16 mg per kg rescue. A vertical arrow marks the 45 to 60 second onset window shared by both sequences.