1062 MESA COUNTY EMS SYSTEM GUIDELINES: RAPID SEQUENCE INDUCTION (RSI) ***** THIS PROTOCOL ONLY APPLIES TO APPROVED ***** *****CRITICAL CARE CERTIFIED PARAMEDICS ***** RAPID SEQUENCE INDUCTION INTUBATION PROCEDURES There are times when patients need to have their airway secured before they have lost their gag reflexes. The following guidelines will be followed by those in the Mesa County EMS System who have attained their Critical Care Paramedic credential from the State of Colorado AND have been through the additional training and approval process mandated by the MCEMSD prior to attempting this procedure. PROCEDURE The following two pages outline the genera procedure for RSI as outlined by the State of Colorado Department of Health and the EMPAC. This will be the basis for proper procedure for RSI in Mesa County. MEDICATIONS In Mesa County, the following medications will be approved: Induction – Ketamine 1.5 mg/kg IV or averages as outlined in drug protocol Paralysis – Rocuronium 1.2 mg/kg IV or averages as outlined in drug protocol Post-paralysis sedation – Fentanyl and midazolam ADDITIONAL APPROVAL This protocol applies ONLY to Paramedics in Mesa County who have successfully obtained the Critical Care endorsement from the State of Colorado, AND who have obtained approval from the EMSMD for the heightened training and CME requirements which accompany this skill. There will be specific, personal education with the EMSMD There will be live patient intubation requirements which must be attained to remain on this protocol There will be ongoing additional CME requirements to remain on this protocol THIS PROTOCOL WILL ONLY APPLY TO PATIENTS 13 YEARS OLD AND GREATER Mesa County EMS System Guidelines Approved March 1, 2019. Next Revision: January 2020 1062 MESA COUNTY EMS SYSTEM GUIDELINES: RAPID SEQUENCE INDUCTION (RSI) Mesa County EMS System Guidelines Approved March 1, 2019. Next Revision: January 2020 1062 MESA COUNTY EMS SYSTEM GUIDELINES: RAPID SEQUENCE INDUCTION (RSI) Mesa County EMS System Guidelines Approved March 1, 2019. Next Revision: January 2020 .