Rapid Sequence Induction (RSI) refers to the fact that the induction agent and neuromuscular blocker are given in quick succession without titration to effect, a cuffed tracheal tube placed in the trachea and the cuff inflated in as little a time as possible. In spite of widespread use there is no evidence available to support or refute the use of RSI to lower aspiration risk. Some of the controversies in RSI will be discussed based on the evidence available.
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