Rapid Sequence Intubation

Rapid sequence intubation (RSI) is an airway management technique that induces immediate unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking agent) and is the fastest and most effective means of controlling the airway in an emergency when the cessation of spontaneous ventilation involves considerable risk if the provider does not intubate or ventilate the patient in a timely manner.

RSI is particularly useful in the patient with an intact gag reflex, a “full” stomach, and a life threatening injury or illness requiring immediate airway control ‘modified’ RSI is a term sometimes used to describe variations on the ‘classic’ RSI approach (e.g. ventilation during apnea, titration of induction agents); modified approaches tend to trade an increased risk of aspiration for other benefits (e.g. prevent respiratory acidosis due to apnea from compounding severe metabolic acidosis).