Rapid Sequence Induction — drug order
Order of medications in RSI
Mnemonic device
Pre-Induce-Paralyze-Place
Mapping
Pre
Pretreat: lidocaine 1.5 mg/kg + fentanyl 1-3 mcg/kg (3 min before induction)
Induce
Induce: propofol 1.5-2.5 mg/kg, etomidate 0.2 mg/kg if hemodynamically borderline, ketamine 1-2 mg/kg if shocked
Paralyze
Paralyze: succinylcholine 1-1.5 mg/kg OR rocuronium 1.2 mg/kg
Place
Place ETT after fasciculations stop (sux) or 60-90 sec (roc)
Clinical note: Modified RSI = mask ventilation if SpO₂ drops, common in obese / pregnant / pediatric. Cricoid pressure controversial in modern practice.