Rapid-sequence intubation (RSI) is the nearly simultaneous administration of a potent intravenous anesthetic agent and a neuromuscular blocking agent to facilitate endotracheal intubation. The process involves preparation, preoxygenation, application of cricoid pressure (Sellick maneuver), induction of anesthesia, neuromuscular blockade, and intubation without attempting mask ventilation. While there remain advocates of other airway management methods, this technique provides unsurpassed airway access while minimizing complications. Its use in critically ill children is well described, and it is regarded as the first choice in the absence of contraindications (see below).1 U
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