Challenges and advances in intubation: rapid sequence intubation

Emerg Med Clin North Am. 2008 Nov;26(4):1043-68, x. doi: 10.1016/j.emc.2008.10.002.


Rapid sequence intubation is the process involving administration of a sedative (eg, induction agent) followed almost immediately by a neuromuscular blocking agent to facilitate endotracheal intubation The purpose of emergency RSI is to make emergent intubation easier and safer, thereby increasing the success rate of intubation while decreasing the complications. Possible disadvantages are complications from the additional drugs, prolonged intubation with hypoxia, and precipitating an emergent or crash airway. Controversy has arisen regarding various steps in RSI; however, RSI remains the standard of care in emergency medicine airway management.

Publication types

  • Review

MeSH terms

  • Airway Obstruction / physiopathology
  • Airway Obstruction / surgery
  • Airway Obstruction / therapy*
  • Conscious Sedation*
  • Emergency Service, Hospital / standards*
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Intubation, Intratracheal / methods*
  • Intubation, Intratracheal / trends
  • Neuromuscular Blocking Agents / pharmacology*
  • Neuromuscular Junction / anatomy & histology
  • Neuromuscular Junction / drug effects*
  • Preoperative Care / methods
  • Respiratory Aspiration / prevention & control


  • Hypnotics and Sedatives
  • Neuromuscular Blocking Agents