Rapid sequence intubation in adults

INTRODUCTION — The first task of any clinician managing an acutely unstable patient is to secure the airway. In most circumstances, emergency clinicians use rapid sequence intubation (RSI) to accomplish this task. RSI incorporates a rapidly acting sedative (ie, induction) agent and a neuromuscular blocking (ie, paralytic) agent to create optimal intubating conditions and enable rapid control of the airway. RSI presupposes the patient is at risk for aspiration of stomach contents and incorporates medications and techniques to minimize this risk. Use of RSI also helps to mitigate the potential adverse effects of airway manipulation.