RSI has been the go-to approach to emergency airway management for decades, however, the rise of video laryngoscope and the rise of ketamine as an induction agent have opened up alternatives to RSI that should be considered in the right context. In this lecture, we will discuss what RSI is and how it differs from paralytic-only intubation, ketamine-only breathing intubation, topicalized awake intubation, and delayed sequence intubation.