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Re: PAI (MFI) vs. RSI

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> With regard to Dr. Bledsoe's statement about PAI, I would have to say that

> the jury is also still out on this.

>

I would also like to comment on this issue. I have been using RSII for

almost 10 years altogether. My experience is that now, after more and more

experience, I use medication (sedation) - facilitated only much more often than

I

use full RSII.

Dr. Bledsoe's comments re: the physiology are, of course, absolutely correct.

But not all patients are at risk and/or susceptible to ICP changes

secondary to airway articulation. In fact...relatively few patients are. I

use MFI

extensively in COPD, CHF, PN, etc. patients with great success. And I teach

it to whoever will listen, as one more tool. Everyone on this list who has

used RSII knows that in many...perhaps most....patients, the anatomic changes

associated with paralysis will lead to the airway view moving one (or more)

positions to the right on the Mallanpati scale. Said another way, sux will

change a grade 2 to a grade 3, by collapsing the pillars and the supra-glottic

muscles. Many times this is not an issue.....but sometimes it *is*.

So, I do not agree with when he says it has no place. I believe it

does.

Thanks,

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