Which of the following steps is NOT involved in pediatric rapid sequence intubation (RSI)?

In the practice of pediatric rapid sequence intubation (RSI), certain steps are considered essential to ensure the safety and efficacy of the procedure, while others may not be directly involved in the intubation process itself.

Cervical collar placement prior to intubation is not a specific step involved in the RSI protocol. While it is crucial in managing cervical spine precautions, especially in cases of trauma, it does not directly relate to the pharmacological preparation or the technical steps of the intubation process. The goal of RSI is to quickly secure the airway while minimizing the risk of aspiration and providing hemodynamic stability. Preparatory medications and the correct choice of equipment, such as endotracheal tube sizing, are critical elements of this process.

In contrast, atropine pretreatment is considered for children under 10 to reduce the risk of bradycardia during intubation. Lidocaine is used as a pretreatment in cases of suspected head trauma to blunt the increase in intracranial pressure that can occur during the procedure. Choosing an appropriately sized endotracheal tube by reference to finger size is a common and practical approach in pediatrics to ensure proper airway management.

Therefore, the focus on pharmacological measures and equipment selection highlights