RSI is a common high stakes procedure done in emergent airways in the ER, but imagine how your patients must feel if they regain awareness during paralysis. One patient said "it was the worst pain he'd ever had and it was unbearable." How can your ER team avoid unwittingly contributing to this pain? Nyssa and Lisa examine a study that reveals the prevalence of awareness with paralysis in the ER and discuss how to keep it from happening to your patient.