Back 2 Basics Series: Your Simple RSI Checklist - SOAP ME

The use of a checklist during high stress medical procedures is often recommended. Rapid sequence intubation (RSI) is a classic situation where having a checklist can ensure adequate preparation however, if you don’t have a checklist – this simple mnemonic will make sure you are well prepared for a successful intubation.

Mnemonic – “SOAP ME” Suction Yankauer suction placed under the mattress on the right side, head of bed (x2 if GI bleed, vomiting, or lots of secretions) Oxygen Bag valve mask (with PEEP valve) ready

Non-rebreather mask on patient (O 2 wide open)

wide open) Nasal cannula on the patient (with 15L O 2 ) during RSI Airways Oral, nasal airways

2 ETT (expected size & one size below) w/ balloons checked, & stylet straight to cuff

1 ETT ready for video laryngoscopy (curved stylet needed)

Rescue devices (Laryngeal mask airway, scalpel, etc.) Positioning Ear-to-sternal notch position

Ramped if obese Monitors & Meds Continuous monitoring devices

RSI Meds: Drawn up in carefully considered doses, labeled syringes Sedative (Ketamine, etomidate, etc.) Paralytic (rocuronium, succinylcholine)

Post intubation sedation meds (Propofol, fentanyl, etc) EtCO 2 & other Equipment Continuous EtCO 2 or at least color-change device to confirm successful intubation

or at least color-change device to confirm successful intubation Bougie placed under the mattress next to yankauer suction

2 laryngoscopes (MAC 3 & 4) with lights checked.

Video laryngoscope plugged in & turned on

The SOAP ME mnemonic is a quick and useful technique to remember only the basics of airway management and preparation. Always remember to also assign roles to team members and communicate clearly to maximize your chances of success.