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Rapid sequence intubation (RSI) denotes the use of a neuromuscular blocking (paralytic) agent combined with a sedative or induction agent to facilitate ETI of a patient with intact protective reflexes. The salient goals of RSI are to facilitate rapid sedation and paralysis of the patient and insertion of the endotracheal tube while effecting minimum physiological disturbances (heart rate, blood pressure, intracerebral pressure, etc.). Current prehospital RSI practices closely parallel emergency department practices. The general clinical indications for prehospital RSI include the need for airway and ventilatory control in patients with intact protective airway reflexes: for example, victims of traumatic brain injury.