Advanced airway management in the pediatric emergency department is the first line of management in a critically ill child. Clinical condition of the patient, skills of ER (emergency room) personnel, influence outcome of this procedure. This prospective study describes the success rates, immediate complications and the environmental, patient and physician factors that influence complication rates of rapid sequence intubation (RSI) in the Pediatric Emergency Department of a tertiary care Pediatric Hospital, over a period of 1year, Of the 64 intubations, 39% were in infants, 43.7% had pre-existing illness, 28% required bag and mask ventilation for preoxygenation. Most common complication was right bronchus intubation. Majority were intubated at the first attempt. Success at first attempt, and complications correlated with the experience of doctors. Conclusion: ER doctors are highly competent in performing RSI with acceptable complication rates. The need for using bag valve mask during RSI is not uncommon. Every paediatrician should be trained in RSI for securing the airway of a critically ill child.

Keywords: Rapid sequence intubation; Intubation; Bag valve mask.