Editing Rapid sequence induction (section)

== Complications ==
There are several possible complications associated with RSI. The most concerning complication is [[Advanced airway management|airway management]] in a paralyzed patient.<ref name=":1">{{Cite journal | vauthors = Sinclair RC, Luxton MC |date=April 2005 |title=Rapid sequence induction  |journal=Continuing Education in Anaesthesia Critical Care & Pain |language=en |volume=5 |issue=2 |pages=45–48 |doi=10.1093/bjaceaccp/mki016|doi-access=free }}</ref> As the sequence of RSI dictates that the patient is paralyzed prior to obtaining adequate airway access, there is the possibility that the patient is difficult to intubate. If unable to secure an airway access, the patient may be in a "cannot intubate, cannot ventilate" situation where the apneic period is prolonged and the patient does not receive oxygen.<ref name=":1" /> This prolonged period of [[apnea]] can lead to brain damage, [[circulatory collapse]], and death. In this situation, one must consider the difficult airway algorithm<ref>{{cite journal | vauthors = Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, Fiadjoe JE, Greif R, Klock PA, Mercier D, Myatra SN, O'Sullivan EP, Rosenblatt WH, Sorbello M, Tung A | display-authors = 6 | title = 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway | journal = Anesthesiology | volume = 136 | issue = 1 | pages = 31–81 | date = January 2022 | pmid = 34762729 | doi = 10.1097/aln.0000000000004002 | s2cid = 244040430 | doi-access = free }}</ref> with the possibility of waking the patient with paralytic reversal medications such as [[sugammadex]].<ref name=":1" />

Conversely, the induction drugs classically used for RSI have short durations of action, wearing off after only minutes. This confers a degree of [[fault tolerance]] on the procedure when it is used in [[elective surgery|elective]] or semi-elective settings: if intubation is unsuccessful, and if the clinical condition allows it, the procedure may be abandoned and the patient should regain the ability to protect their own airway sooner than would be the case under routine methods of induction. 
Another possible complication is [[anaphylaxis]] in response to a neuromuscular blockade.<ref name=":2">{{cite journal | vauthors = Reitter M, Petitpain N, Latarche C, Cottin J, Massy N, Demoly P, Gillet P, Mertes PM | display-authors = 6 | title = Fatal anaphylaxis with neuromuscular blocking agents: a risk factor and management analysis | journal = Allergy | volume = 69 | issue = 7 | pages = 954–959 | date = July 2014 | pmid = 24813248 | doi = 10.1111/all.12426 }}</ref> Neuromuscular blockade agents are considered one of the highest anaphylaxis-inducing substances in the operating room, along with [[Latex allergy|latex]], [[penicillin]], and [[chlorhexidine]].<ref name=":2" /> In this case, the anesthesiologist must be able to treat the anaphylaxis and resulting complications in a compromised patient.<ref name=":1" />
[[File:Larynx external en.svg|thumb|Upper airway anatomy]]
The process of applying [[cricoid pressure]] during Sellick's maneuver can introduce complications such as [[Larynx|laryngeal]] distortion, failure to completely occlude the [[esophagus]], and potential esophageal rupture if the patient is actively vomiting.<ref name=":1" />