RSI is rapid sequence intubation, a procedure performed to emergently intubate a patient with an intact gag reflex in cases of acute respiratory failure and/or cardiovascular collapse. As a nurse working in the emergency department or ICU, you will be obtaining and may be administering the medications used to perform a rapid sequence intubation. Please be aware of your scope of practice and facility protocol regarding the administration of these medications. In some cases, the medications can only be administered by a physician.

Which combination of medications the physician chooses will vary depending on a variety of factors including the patient’s condition and physician preference. A common combination is a sedative with a short-acting paralytic, though analgesics may also be utilized. This episode provides an overview of the medications commonly utilized for RSI:

  • Propofol
  • Succinylcholine
  • Rocuronium
  • Vecuronium
  • Etomidate
  • Ketamine
  • Fentanyl
  • Midazolam


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