Lesson 16 of 16
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Rapid Sequence Intubation (RSI): RSI Summary & References


  • RSI is a complex procedure that require medication to assist with the establish of an advanced airway
  • Induction medications are utilized to adequately sedate a patient prior to paralysis and place of an advanced airway
  • Patient specific factors should influence which induction agent and paralytic that should be used for RSI
  • Post-intubation sedation is a commonly forgotten component of the 7 P’s of intubation and medications should be planned prior to intubation.


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  • April MD, Arana A, Pallin DJ, Schauer SG, Fantegrossi A, Fernandez J, Maddry JK, Summers SM, Antonacci MA, Brown CA 3rd; NEAR Investigators. Emergency Department Intubation Success With Succinylcholine Versus Rocuronium: A National Emergency Airway Registry Study. Ann Emerg Med. 2018 Dec;72(6):645-653. doi: 10.1016/j.annemergmed.2018.03.042. Epub 2018 May 7. PMID: 29747958.
  • Tran DTT, Newton EK, Mount VAH, Lee JS, Mansour C, Wells GA, Perry JJ. Rocuronium vs. succinylcholine for rapid sequence intubation: a Cochrane systematic review. Anaesthesia. 2017 Jun;72(6):765-777. doi: 10.1111/anae.13903. PMID: 28654173.
  • Patanwala AE, Erstad BL, Roe DJ, Sakles JC. Succinylcholine Is Associated with Increased Mortality When Used for Rapid Sequence Intubation of Severely Brain Injured Patients in the Emergency Department. Pharmacotherapy. 2016 Jan;36(1):57-63. doi: 10.1002/phar.1683. PMID: 26799349.
  • Patanwala AE, Stahle SA, Sakles JC, Erstad BL. Comparison of succinylcholine and rocuronium for first-attempt intubation success in the emergency department. Acad Emerg Med. 2011 Jan;18(1):10-4. doi: 10.1111/j.1553-2712.2010.00954.x. Epub 2010 Dec 23. PMID: 21182564.
  • Weiss JH, Gratz I, Goldberg ME, Afshar M, Insinga F, Larijani G. Double-blind comparison of two doses of rocuronium and succinylcholine for rapid-sequence intubation. J Clin Anesth. 1997 Aug;9(5):379-82. doi: 10.1016/s0952-8180(97)00065-2. PMID: 9257203.
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  • Neuromuscular Blocking Agents. In: Butterworth IV JF, Mackey DC, Wasnick JD. Butterworth IV J.F., & Mackey D.C., & Wasnick J.D.(Eds.),Eds. John F. Butterworth IV, et al.eds. Morgan & Mikhail’s Clinical Anesthesiology, 6e. McGraw Hill; 2018. Accessed September 3, 2021.
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