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Rapid Sequence Intubation Medication Therapies: A Review in Light of Recent Drug Shortages

Mason, Molly A. PharmD, BCPS; Weant, Kyle A. PharmD, BCPS; Baker, Stephanie N. PharmD, BCPS

Section Editor(s): Weant, Kyle A. PharmD, BCPS; Column Editor

Advanced Emergency Nursing Journal: January/March 2013 - Volume 35 - Issue 1 - p 16–25
doi: 10.1097/TME.0b013e31827fb706
Applied Pharmacology

Rapid sequence intubation is a stepwise process developed to assist health care providers in placing emergent artificial airways for patients requiring assisted ventilation. This practice includes routine administration of sedative and neuromuscular blocking agent (NMBA) medications for patient comfort during endotracheal tube placement. Members of the multidisciplinary team should be well educated about the various medications used during this process to ensure safe medication practices in an emergent situation. Recent drug shortages have forced many health care professionals to use alternative medications with which they are less familiar. The intent of this review is to familiarize health care providers with the pharmacology and adverse effect profiles of alternative sedative and NMBA medications used in emergent airway placement in light of recent drug shortages.

Department of Pharmacy Services, Indiana University Health Methodist Hospital, Indianapolis, Indiana (Dr Mason); North Carolina Public Health Preparedness and Response, Raleigh, North Carolina (Dr Weant); North Carolina Department of Public Health, Raleigh, North Carolina (Dr Weant); Department of Pharmacy Services, UK Health Care, Lexington, Kentucky (Dr Baker); and Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky (Dr Baker).

Corresponding Author: Molly A. Mason, PharmD, BCPS, Department of Pharmacy Services, Indiana University Health Methodist Hospital, 1701 North Senate Blvd, AG401, Indianapolis, IN 46202 (

Disclosure: The authors report no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.