Sequential Order of RSI on Tracheal Intubation

July 28, 2026 updated by: Zhongnan Hospital

The Impact of Sequential Order of Emergency Sedation and Neuromuscular Blocking Agent During Rapid Sequence Induction on Tracheal Intubation

This clinical trial aims to understand the effect of the order of administration of Neuromuscular Blocking Agents (NMBAs) and sedatives on the success rate of intubation during Rapid Sequence Intubation (RSI) in the emergency department. The main questions to be answered include:

  1. The impact of sequential drug administration order during rapid sequence induction (RSI) on first-pass intubation success rates.
  2. Time to successful intubation
  3. Hypoxia incidence (SpO₂ <90%)
  4. Risk of post-traumatic stress disorder (PTSD)
  5. Procedure-related complications

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

380

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
      • Wuhan, China
        • Zhongnan Hospital of Wuhan University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • in ED/EICU required emergency intubation
  • RSI required

Exclusion Criteria:

  • Pregnancy
  • do not intubation orders
  • Declined participation
  • Other trials
  • Non-emergent cases
  • Active CPR

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Sedative to NMBA
Sedative(Propofol) →within 30s→ NMBA(Rocuronium) → Intubation
Experimental: NMBA to Sedative
NMBA(Rocuronium) →within 30s→ Sedative(Propofol) → Intubation
Procedure: Drug Sequence
Control: Sedative ( Propofol ) →within 30s→ NMBA ( Rocuronium ) → Intubation → 5min → Measure vital signs → After treatment → Remove tracheal intubation→ Recall of intubation Intervention: NMBA ( Rocuronium ) →within 30s→ Sedative(Propofol) → Intubation → 5min → Measure vital signs → After treatment → Remove tracheal intubation→ Recall of intubation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
First-pass success rate
Time Frame: Perioperative

Successful intubation on the first attempt, confirmed by any one of:

Direct visualization of the ETT passing through vocal cords Bilateral breath sounds on auscultation Fiberoptic bronchoscopic confirmation of tracheal placement Sustained end-tidal CO₂ waveform (EtCO₂ >15 mmHg for ≥3 breaths)
Perioperative

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to intubation
Time Frame: Perioperative
from laryngoscopy start to confirmation (seconds)
Perioperative
Intubation recall
Time Frame: From drug injection to Remove the endotracheal tube
From drug injection to Remove the endotracheal tube
Changes in SBP
Time Frame: Perioperative
ΔSBP, :SBPₜ₀ - SBPₜ₁ ; (SBPₜ₀ - SBPₜ₁)/SBPₜ₀ × 100%
Perioperative
Changes in HR
Time Frame: Perioperative
ΔHR (absolute and percentage change):HRₜ₀ - HRₜ₁ ; (HRₜ₀ - HRₜ₁)/HRₜ₀ × 100%
Perioperative
Changes in SpO₂
Time Frame: Perioperative
ΔSpO₂ (absolute and percentage change):SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ ; (SpO₂ₜ₀ - SpO₂ₜ₂ₘᵢₙ)/SpO₂ₜ₀ × 100%
Perioperative

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Zhongnan Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2025

Primary Completion (Actual)

June 1, 2026

Study Completion (Actual)

June 30, 2026

Study Registration Dates

First Submitted

July 23, 2026

First Submitted That Met QC Criteria

July 28, 2026

First Posted (Actual)

August 3, 2026

Study Record Updates

Last Update Posted (Actual)

August 3, 2026

Last Update Submitted That Met QC Criteria

July 28, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • ZKL-KY-2024-008 (Other Grant/Funding Number: China Health Charity Foundation)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe