Paralytic or Not when Intubating. 

We use RSI for intubation. Most of the time I use a paralytic like succinylcholine or rocuronium. There are sometimes times one should be cautious and consider awake intubation or even sedation only medication enabled intubation with the appropriate preparation and drug, i.e. ketamine. RSI is part of the culture I was raised in. Some cultures or tribes of medicine in the hospital weren't hence hesitancy is present when the question is asked about the use of paralytic during intubation. I don't call them the misnamed muscle relaxant another specialty calls them.