RapidSequence Intubation RSI is the simultaneous administration of an induction and a neuromuscular blocking agent to facilitate tracheal intubation, and

is the preferred method for emergency intubation

To preoxygenate, administer 100% oxygen for 3 minutes, using a nonrebreather mask supplied with 15 L/min of oxygen. Nasal cannulas do not provide optimal preoxygenation

After intubation, a chest x-ray is used to identify mainstem bronchus intubation or to locate the ETT tip. A chest xray does not distinguish ETT placement in the trachea from the esophagus

RapidSequence Intubation

Lidocaine = Laryncosope Opioid= aOrtic dissection Atropine= brAdycardia

Pretreatment with a nondepolarizing neuromuscular blocking agent, such as rocuronium, is no longer recommended.

Succinylcholine can provide excellent intubation conditions and is preferable to nondepolarizing agents for RSI in the ED Serum potassium will transiently rise an average of 0.5 mEq/L with succinylcholine Do not use succinylcholine in patients with suspected preexisting hyperkalemia or myopathies or myasthenia gravis

Pretreatment with a nondepolarizing neuromuscular blocking agent, such as rocuronium, is no longer recommended.

Ketamine is not a preferred agent for the elderly or for patients with a potential for cardiac ischemia

NEutral bp = Etomedate DEcrease ICP = Etomedate,Propofal Broncho dilater = Ketamine