Rapid sequence intubation (RSI) is a particular type of endotracheal intubation that aims to quickly and effectively induce sedation and paralysis in a patient who’s at high risk for aspiration or impending airway compromise.

RSI is performed by first administering a sedative, followed rapidly by a paralytic, before an attempt is made to intubate. There has been much debate over which type of neuromuscular blockade should be used to paralyze patients during RSI, and many EMS systems only offer RSI with one particular medication over the other, and have been exclusively taught on one first-line medication.

In a recent JEMS article, Joslyn Joseph, DO, EMT; Dan Rice, MD, MICP; Joseph E. DiCorpo, BSC, MMSc, PA and Mark A. Merlin, DO, EMT-P, FACEP, compare and contrast two of the more popular drugs used for RSI. Which one will win in “Succinylcholine vs. Rocuronium: Battle of the Paralytics”?