Which patients might require rapid sequence intubation (RSI)?

Rapid sequence intubation (RSI) is indicated for patients who present with a compromised airway or severe respiratory distress and are unable to protect their airway. This procedure is critical for ensuring that the airway remains patent and secure, particularly when there are concerns about the patient's ability to maintain their airway due to altered mental status, severe respiratory failure, or other conditions that may lead to airway obstruction.

When a patient is in respiratory distress and cannot protect their airway, they are at a higher risk for aspiration and inadequate ventilation, which can lead to life-threatening consequences. Hence, performing RSI allows for the timely and effective management of such patients by facilitating rapid endotracheal intubation, ensuring better oxygenation and ventilation.

In contrast, patients with stable vital signs and no respiratory distress do not present the same urgency for airway management, and those who are fully conscious and cooperative typically do not require intubation, as they can maintain their own airway. Patients experiencing chest pain may also not necessarily need intubation unless there are other complicating factors impacting their respiratory status or airway protection. Thus, option B accurately identifies the specific scenario in which RSI is warranted.