Prehospital Rapid Sequence Intubation

What Is Prehospital Rapid Sequence Intubation?

Prehospital Rapid Sequence Intubation (RSI) is an advanced airway management technique used by firefighter/medics and paramedics to secure the airway of critically ill or injured patients in the field. It involves the administration of a sedative followed immediately by a neuromuscular blocking agent to facilitate endotracheal intubation under controlled conditions. Not to be confused with basic airway adjunct placement, RSI requires specialized training and is often performed in high-acuity scenarios such as trauma or respiratory failure within the Hot Zone or during critical care transport.

Why Prehospital Rapid Sequence Intubation Matters on the Fireground

RSI enables rapid and controlled airway control, minimizing the risk of aspiration and hypoxia in unstable patients. Its proper use improves patient outcomes by ensuring adequate ventilation and oxygenation before hospital arrival, which is critical in time-sensitive emergencies managed under ICS or NIMS protocols.