What is the best method for a vomiting patient who needs airway management and tube placement?

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The main idea here is securing a protected airway quickly to prevent aspiration in a patient who’s actively vomiting. The best method is rapid sequence intubation, which combines fast-acting induction and a paralytic to induce loss of airway reflexes and allow immediate placement of a cuffed endotracheal tube. This approach minimizes the time the stomach contents can regurgitate and provides a definitive airway with protection against aspiration. Supraglottic airways don’t reliably protect the lungs from vomitus, so they’re not ideal when vomiting is present. Simply reducing gastric volume isn’t an airway management method by itself, and cricoid pressure is controversial and not the sole determinant of the airway plan—RSI is the strategy that best achieves rapid, controlled airway protection in this scenario.