Table of contents

Rapid sequence induction and intubation

What's new

Added 2023 SCCM, 2022 ESAIC, and 2017 SFAR/SFRL guidelines for rapid sequence induction and intubation.


Key sources

The following summarized guidelines for the management of rapid sequence induction and intubation are prepared by our editorial team based on guidelines from the Society of Critical Care Medicine (SCCM 2023), the European Society of Anaesthesiology and Intensive Care (ESAIC 2022), and the French Society of Anesthesia and Intensive Care (SFAR/SFRL 2017). ...
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Respiratory support

Positioning: as per SCCM 2023 guidelines, consider using the head and torso inclined (semi-Fowler) position during rapid sequence intubation.
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More topics in this section

  • Preoxygenation

Medical management

Induction agents
As per SCCM 2023 guidelines:
Administer a sedative-hypnotic induction agent when a neuromuscular-blocking agent is used for intubation.
Recognize that there is no difference between etomidate and other induction agents administered for rapid sequence intubation with respect to mortality or the incidence of hypotension or vasopressor use during the peri-intubation period and through hospital discharge.

More topics in this section

  • Neuromuscular blockers

  • Periprocedural vasopressors

  • Postprocedural corticosteroids

Nonpharmacologic interventions

Nasogastric tube decompression: as per SCCM 2023 guidelines, consider performing nasogastric tube decompression when the benefit outweighs the risk in patients at high risk of regurgitation of gastric contents undergoing rapid sequence intubation.