Rapid sequence intubation: a systemic literature review

Martynas Zaremba1, Valdonė Ališkevičiūtė1, Vykinta Zeleckytė1

 1 Medical Academy of the Lithuanian University of Health Sciences


Rapid sequence intubation is a method, that allows to quickly secure the airway for patients who are at risk of aspiration. Rapid sequence intubation is a technique, which is widely used in emergency situations and it accounts for 85 % of all emergency room and 75 % ICU intubations. The aim of our article was to evaluate the technique, indications and complications associated with rapid sequence intubation as well as to identify the most commonly used medications. We analyzed medical publications using international databases like UpToDate, PubMed, Cohrane, MedScape. Certain keywords and their combinations were used to find specific medical articles.

                  Conclusions: 1. Rapid sequence intubation is a common practice in emergency situations and is most frequently used when a patient has a high risk of aspiration. 2. The most common indications for rapid sequence intubation are: aspiration, general anesthesia, respiratory failure, head traumas and Glasgow coma scale < 8. 3. Two types of drugs are used in rapid sequence intubation – induction and neuromuscular blocking agents. The choice of specific drugs depends on the desired rate of induction and relaxation, also the patient’s condition and comorbidities. 4. The most common complications associated with rapid sequence intubation are: failed intubation, difficult intubation, esophageal intubation, vomiting, pneumothorax and airway trauma.

Keywords: rapid sequence, endotracheal intubation, sedation, airways.