Name two neuromuscular blocking agents used during RSI and their typical doses.

• A. Succinylcholine 1.5-2 mg/kg IV; Rocuronium 0.6-1.2 mg/kg IV.
• B. Vecuronium 2 mg/kg; Rocuronium 0.1 mg/kg.
• C. Succinylcholine 0.2 mg/kg; Atracurium 0.1 mg/kg.
• D. Pancuronium 0.8 mg/kg; Vecuronium 0.05 mg/kg.

Answer: (A)

In RSI you want rapid onset neuromuscular blockade to secure the airway quickly and limit aspiration risk. Succinylcholine, a depolarizing blocker, achieves this with very fast onset (about 30–60 seconds) and a short duration, so giving about 1.5–2 mg/kg IV typically paralyzes the vocal cords and surrounding muscles quickly for intubation. If succinylcholine is not suitable, rocuronium at a higher dose can provide a comparable rapid onset—roughly 0.6–1.2 mg/kg IV—giving intubating conditions within a similar time frame and with a more predictable recovery window. Other drugs or lower doses either take longer to take effect or last much longer, which is why they’re not chosen for rapid sequence intubation.