Rabbit Hole: Rapid Sequence Intubation (RSI)

Primary Literature

Induction Agents

• Jabre P, Combes X, Lapostolle F, Dhaouadi M, Ricard-Hibon A, Vivien B, Bertrand L, Beltramini A, Gamand P, Albizzati S, Perdrizet D, Lebail G, Chollet-Xemard C, Maxime V, Brun-Buisson C, Lefrant JY, Bollaert PE, Megarbane B, Ricard JD, Anguel N, Vicaut E, Adnet F; KETASED Collaborative Study Group. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet. 2009 Jul 25;374(9686):293-300. doi: 10.1016/S0140-6736(09)60949-1. Epub 2009 Jul 1. PMID: 19573904.
• Wan C, Hanson AC, Schulte PJ, Dong Y, Bauer PR. Propofol, Ketamine, and Etomidate as Induction Agents for Intubation and Outcomes in Critically Ill Patients: A Retrospective Cohort Study. Crit Care Explor. 2021 May 24;3(5):e0435. doi: 10.1097/CCE.0000000000000435. PMID: 34046636; PMCID: PMC8148417.
• Upchurch CP, Grijalva CG, Russ S, Collins SP, Semler MW, Rice TW, Liu D, Ehrenfeld JM, High K, Barrett TW, McNaughton CD, Self WH. Comparison of Etomidate and Ketamine for Induction During Rapid Sequence Intubation of Adult Trauma Patients. Ann Emerg Med. 2017 Jan;69(1):24-33.e2. doi: 10.1016/j.annemergmed.2016.08.009. PMID: 27993308; PMCID: PMC5180365.
• Dietrich SK, Mixon MA, Rogoszewski RJ, Delgado SD, Knapp VE, Floren M, Dunn JA. Hemodynamic Effects of Propofol for Induction of Rapid Sequence Intubation in Traumatically Injured Patients. Am Surg. 2018 Sep 1;84(9):1504-1508. PMID: 30268185.
• Baekgaard JS, Eskesen TG, Moo Lee J, Ikast Ottosen C, Bennett Gyldenkaerne K, Garoussian J, Ejlersgaard Christensen R, Sillesen M, King DR, Velmahos GC, Rasmussen LS, Steinmetz J. Ketamine for rapid sequence intubation in adult trauma patients: A retrospective observational study. Acta Anaesthesiol Scand. 2020 Oct;64(9):1234-1242. doi: 10.1111/aas.13651. Epub 2020 Jul 6. PMID: 32531068.
• Ferguson I, Alkhouri H, Fogg T, Aneman A. Ketamine use for rapid sequence intubation in Australian and New Zealand emergency departments from 2010 to 2015: A registry study. Emerg Med Australas. 2019 Apr;31(2):205-210. doi: 10.1111/1742-6723.13114. Epub 2018 Jun 11. PMID: 29888875.
• Farrell NM, Killius K, Kue R, Langlois BK, Nelson KP, Golenia P. A Comparison of Etomidate, Ketamine, and Methohexital in Emergency Department Rapid Sequence Intubation. J Emerg Med. 2020 Oct;59(4):508-514. doi: 10.1016/j.jemermed.2020.06.054. Epub 2020 Jul 29. PMID: 32739131.
• Perier F, Chateauneuf AL, Jacq G, Holleville M, Schnell D, Merceron S, Cavelot S, Richard O, Legriel S; ICTAL Study Group. Comparison of etomidate and sodium thiopental for induction during rapid sequence intubation in convulsive status epilepticus: A retrospective single-center study. Seizure. 2018 Oct;61:170-176. doi: 10.1016/j.seizure.2018.08.022. Epub 2018 Aug 28. PMID: 30176574.
• Cagliani JA, Ruhemann A, Molmenti E, Smith C, Coppa G, Barrera R. Association between Etomidate Use for Rapid Sequence Intubation and Adrenal Insufficiency in Sepsis. Cureus. 2021 Feb 19;13(2):e13445. doi: 10.7759/cureus.13445. PMID: 33767929; PMCID: PMC7982295.
• Pollack MA, Fenati GM, Pennington TW, Olvera DJ, Wolfe A Jr, Owens M, Davis DP. The Use of Ketamine for Air Medical Rapid Sequence Intubation Was Not Associated With a Decrease in Hypotension or Cardiopulmonary Arrest. Air Med J. 2020 Mar-Apr;39(2):111-115. doi: 10.1016/j.amj.2019.11.003. Epub 2019 Dec 19. PMID: 32197687.
• Zuckerbraun NS, Pitetti RD, Herr SM, Roth KR, Gaines BA, King C. Use of etomidate as an induction agent for rapid sequence intubation in a pediatric emergency department. Acad Emerg Med. 2006 Jun;13(6):602-9. doi: 10.1197/j.aem.2005.12.026. Epub 2006 Apr 24. PMID: 16636355.
• Lyon RM, Perkins ZB, Chatterjee D, Lockey DJ, Russell MQ; Kent, Surrey & Sussex Air Ambulance Trust. Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia. Crit Care. 2015 Apr 1;19(1):134. doi: 10.1186/s13054-015-0872-2. PMID: 25879683; PMCID: PMC4391675.
• Bruder EA, Ball IM, Ridi S, Pickett W, Hohl C. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients. Cochrane Database Syst Rev. 2015 Jan 8;1(1):CD010225. doi: 10.1002/14651858.CD010225.pub2. PMID: 25568981; PMCID: PMC6517008.
• Tekwani KL, Watts HF, Sweis RT, Rzechula KH, Kulstad EB. A comparison of the effects of etomidate and midazolam on hospital length of stay in patients with suspected sepsis: a prospective, randomized study. Ann Emerg Med. 2010 Nov;56(5):481-9. doi: 10.1016/j.annemergmed.2010.05.034. Epub 2010 Sep 15. PMID: 20828877.
• White PF. Comparative evaluation of intravenous agents for rapid sequence induction–thiopental, ketamine, and midazolam. Anesthesiology. 1982 Oct;57(4):279-84. doi: 10.1097/00000542-198210000-00005. PMID: 7125264.
• Sivilotti ML, Ducharme J. Randomized, double-blind study on sedatives and hemodynamics during rapid-sequence intubation in the emergency department: The SHRED Study. Ann Emerg Med. 1998 Mar;31(3):313-24. PMID: 9506488.
• Sibley A, Mackenzie M, Bawden J, Anstett D, Villa-Roel C, Rowe BH. A prospective review of the use of ketamine to facilitate endotracheal intubation in the helicopter emergency medical services (HEMS) setting. Emerg Med J. 2011 Jun;28(6):521-5. doi: 10.1136/emj.2009.088237. Epub 2010 Oct 6. PMID: 20926628.
• Hidalgo DC, Amin V, Hukku A, Kutlu K, Rech MA. Etomidate Use for Rapid Sequence Intubation Is Not Associated With Nosocomial Infection. J Pharm Pract. 2020 Dec 11:897190020979610. doi: 10.1177/0897190020979610. Epub ahead of print. PMID: 33302788.
• McPhee LC, Badawi O, Fraser GL, Lerwick PA, Riker RR, Zuckerman IH, Franey C, Seder DB. Single-dose etomidate is not associated with increased mortality in ICU patients with sepsis: analysis of a large electronic ICU database. Crit Care Med. 2013 Mar;41(3):774-83. doi: 10.1097/CCM.0b013e318274190d. PMID: 23318491.

Parlaytic Agents

• 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.
• Li G, Cheng L, Wang J. Comparison of Rocuronium with Succinylcholine for Rapid Sequence Induction Intubation in the Emergency Department: A Retrospective Study at a Single Center in China. Med Sci Monit. 2021 Jan 14;27:e928462. doi: 10.12659/MSM.928462. PMID: 33441534; PMCID: PMC7814511.
• Marsch SC, Steiner L, Bucher E, Pargger H, Schumann M, Aebi T, Hunziker PR, Siegemund M. Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial. Crit Care. 2011 Aug 16;15(4):R199. doi: 10.1186/cc10367. PMID: 21846380; PMCID: PMC3387641.
• Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev. 2015 Oct 29;2015(10):CD002788. doi: 10.1002/14651858.CD002788.pub3. PMID: 26512948; PMCID: PMC7104695.
• West JR, O’Keefe BP, Russell JT. Predictors of first pass success without hypoxemia in trauma patients requiring emergent rapid sequence intubation. Trauma Surg Acute Care Open. 2021 Jun 30;6(1):e000588. doi: 10.1136/tsaco-2020-000588. PMID: 34263062; PMCID: PMC8246356.
• West JR, Lott C, Donner L, Kanter M, Caputo ND. Peri-intubation factors affecting emergency physician choice of paralytic agent for rapid sequence intubation of trauma patients. Am J Emerg Med. 2018 Jul;36(7):1151-1154. doi: 10.1016/j.ajem.2017.11.038. Epub 2017 Nov 20. PMID: 29162438.
• Levin NM, Fix ML, April MD, Arana AA, Brown CA 3rd; NEAR Investigators. The association of rocuronium dosing and first-attempt intubation success in adult emergency department patients. CJEM. 2021 Jul;23(4):518-527. doi: 10.1007/s43678-021-00119-6. Epub 2021 Apr 10. PMID: 33837951.
• Magorian T, Flannery KB, Miller RD. Comparison of rocuronium, succinylcholine, and vecuronium for rapid-sequence induction of anesthesia in adult patients. Anesthesiology. 1993 Nov;79(5):913-8. doi: 10.1097/00000542-199311000-00007. PMID: 7902034.
• 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.
• Smith CE, Kovach B, Polk JD, Hagen JF, Fallon WF Jr. Prehospital tracheal intubating conditions during rapid sequence intubation: rocuronium versus vecuronium. Air Med J. 2002 Jan-Feb;21(1):26-32. doi: 10.1067/mmj.2002.121713. PMID: 11805764.
• 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.
• 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.
• Guihard B, Chollet-Xémard C, Lakhnati P, Vivien B, Broche C, Savary D, Ricard-Hibon A, Marianne Dit Cassou PJ, Adnet F, Wiel E, Deutsch J, Tissier C, Loeb T, Bounes V, Rousseau E, Jabre P, Huiart L, Ferdynus C, Combes X. Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial. JAMA. 2019 Dec 17;322(23):2303-2312. doi: 10.1001/jama.2019.18254. PMID: 31846014; PMCID: PMC6990819.
• 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.
• Hartley EL, Alcock R. Rocuronium Versus Suxamethonium: A Survey of First-line Muscle Relaxant Use in UK Prehospital Rapid Sequence Induction. Prehosp Disaster Med. 2015 Apr;30(2):184-6. doi: 10.1017/S1049023X15000047. Epub 2015 Jan 28. PMID: 25627032.
• Li G, Cheng L, Wang J. Comparison of Rocuronium with Succinylcholine for Rapid Sequence Induction Intubation in the Emergency Department: A Retrospective Study at a Single Center in China. Med Sci Monit. 2021 Jan 14;27:e928462. doi: 10.12659/MSM.928462. PMID: 33441534; PMCID: PMC7814511.
• Larsen PB, Hansen EG, Jacobsen LS, Wiis J, Holst P, Rottensten H, Siddiqui R, Wittrup H, Sørensen AM, Persson S, Engbaek J. Intubation conditions after rocuronium or succinylcholine for rapid sequence induction with alfentanil and propofol in the emergency patient. Eur J Anaesthesiol. 2005 Oct;22(10):748-53. doi: 10.1017/s0265021505001249. PMID: 16211732.

• Andrews JI, Kumar N, van den Brom RH, Olkkola KT, Roest GJ, Wright PM. A large simple randomized trial of rocuronium versus succinylcholine in rapid-sequence induction of anaesthesia along with propofol. Acta Anaesthesiol Scand. 1999 Jan;43(1):4-8. doi: 10.1034/j.1399-6576.1999.430102.x. PMID: 9926179.
• Tang L, Li S, Huang S, et al. Desaturation following rapid sequence induction using succinylcholine vs. rocuronium in overweight patients. Acta Anaesthesiol Scand. 2011;55:203–8
• Leykin Y, Pellis T, Lucca M, Lomangino G, Marzano B, Gullo A. The pharmacodynamic effects of rocuronium when dosed according to real body weight or ideal body weight in morbidly obese patients. Anesth Analg. 2004 Oct;99(4):1086-1089. doi: 10.1213/01.ANE.0000120081.99080.C2. PMID: 15385355.
• Gaszynski TM, Szewczyk T. Rocuronium for rapid sequence induction in morbidly obese patients: a prospective study for evaluation of intubation conditions after administration 1.2 mg kg⁻¹ ideal body weight of rocuronium. Eur J Anaesthesiol. 2011 Aug;28(8):609-10. doi: 10.1097/EJA.0b013e32834753d0. PMID: 21562423.
• Meyhoff CS, Lund J, Jenstrup MT, Claudius C, Sørensen AM, Viby-Mogensen J, Rasmussen LS. Should dosing of rocuronium in obese patients be based on ideal or corrected body weight? Anesth Analg. 2009 Sep;109(3):787-92. doi: 10.1213/ane.0b013e3181b0826a. PMID: 19690247.

Other Interventions

• Korinek JD, Thomas RM, Goddard LA, St John AE, Sakles JC, Patanwala AE. Comparison of rocuronium and succinylcholine on postintubation sedative and analgesic dosing in the emergency department. Eur J Emerg Med. 2014 Jun;21(3):206-11. doi: 10.1097/MEJ.0b013e3283606b89. PMID: 23510899.
• Watt JM, Amini A, Traylor BR, Amini R, Sakles JC, Patanwala AE. Effect of paralytic type on time to post-intubation sedative use in the emergency department. Emerg Med J. 2013 Nov;30(11):893-5. doi: 10.1136/emermed-2012-201812. Epub 2012 Nov 8. PMID: 23139098.
• Kendrick DB, Monroe KW, Bernard DW, Tofil NM. Sedation after intubation using etomidate and a long-acting neuromuscular blocker. Pediatr Emerg Care. 2009 Jun;25(6):393-6. doi: 10.1097/PEC.0b013e3181a7923b. PMID: 19458564.
• Johnson EG, Meier A, Shirakbari A, Weant K, Baker Justice S. Impact of Rocuronium and Succinylcholine on Sedation Initiation After Rapid Sequence Intubation. J Emerg Med. 2015 Jul;49(1):43-9. doi: 10.1016/j.jemermed.2014.12.028. Epub 2015 Mar 19. PMID: 25797938.
• De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, Asehnoune K, Jung B, Futier E, Chanques G, Azoulay E, Jaber S. Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study. Crit Care Med. 2018 Apr;46(4):532-539. doi: 10.1097/CCM.0000000000002925. PMID: 29261566.
• Enright K, Akram S, Hussain A, Powell CVE. The integral role of the clinical pharmacist in drug-assisted intubation at a newly established children’s major trauma center. Int J Clin Pharm. 2021 Aug;43(4):1128-1132. doi: 10.1007/s11096-021-01262-x. Epub 2021 Apr 13. PMID: 33851287; PMCID: PMC8043096.

• Johnson EG, Meier A, Shirakbari A, Weant K, Baker Justice S. Impact of Rocuronium and Succinylcholine on Sedation Initiation After Rapid Sequence Intubation. J Emerg Med. 2015 Jul;49(1):43-9. doi: 10.1016/j.jemermed.2014.12.028. Epub 2015 Mar 19. PMID: 25797938.
• De Jong A, Rolle A, Molinari N, Paugam-Burtz C, Constantin JM, Lefrant JY, Asehnoune K, Jung B, Futier E, Chanques G, Azoulay E, Jaber S. Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study. Crit Care Med. 2018 Apr;46(4):532-539. doi: 10.1097/CCM.0000000000002925. PMID: 29261566.