title: Rapid-sequence intubation: a review of the process and considerations when choosing medications.
abstract: OBJECTIVE
  To summarize published data regarding the steps of rapid-sequence intubation (RSI); review premedications, induction agents, neuromuscular blockers (NMB), and studies supporting use or avoidance; and discuss the benefits and deficits of combinations of induction agents and NMBs used when drug shortages occur.
  
  
  METHODS
  A search of Medline databases (1966-October 2013) was conducted.
  
  
  METHODS
  Databases were searched using the terms rapid-sequence intubation, fentanyl, midazolam, atropine, lidocaine, phenylephrine, ketamine, propofol, etomidate thiopental, succinylcholine, vecuronium, atracurium, and rocuronium. Citations from publications were reviewed for additional references.
  
  
  RESULTS
  Data were reviewed to support the use or avoidance of premedications, induction agents, and paralytics and combinations to consider when drug shortages occur.
  
  
  CONCLUSIONS
  RSI is used to secure a definitive airway in often uncooperative, nonfasted, unstable, and/or critically ill patients. Choosing the appropriate premedication, induction drug, and paralytic will maximize the success of tracheal intubation and minimize complications.
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Stollings
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Diedrich
authors.forename: Lance J
authors.initials: LJ
authors.lastname: Oyen
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Brown
mesh_terms: D014151:Anti-Anxiety Agents / Q000600:supply & distribution / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000600:supply & distribution / Q000627:therapeutic use; D007442:Intubation, Intratracheal / Q000379:methods*; D009466:Neuromuscular Blocking Agents / Q000600:supply & distribution / Q000627:therapeutic use
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents
keywords: etomidate; induction agents; ketamine; neuromuscular blockers; premedications; propofol; rapid-sequence intubation