The EMS Lighthouse Project

E82 - Ketamine v Etomidate for RSI: A Bayesian Meta-Analysis


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The debate about which drug to use for sedation before RSI will... not… die. Advocates for both ketamine and etomidate approach the argument with near-religious zeal. There have been studies. We’ve even covered some here. We need a systematic review and meta-analysis, preferably using an analysis that recognizes this likely isn’t a black-and-white question. That’s where our friend Bayes comes in. Dr. Jarvis is joined by Drs Remle Crowe and CJ Winkler to discuss this paper and what in the hell Bayesian analysis actually is. We get some nice book recommendations in the process. Plus, we check in with ChatGPT for answers.

Oh, BTW... don't take zoological advice from Dr. Winkler. Contrary to his thoughts, Giraffe's do NOT, in fact, have larger hearts than elephants. 

Citations:
1. Koroki T, Kotani Y, Yaguchi T, Shibata T, Fujii M, Fresilli S, Tonai M, Karumai T, Lee TC, Landoni G, Hayashi Y. Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17;28(1):48. doi: 10.1186/s13054-024-04831-4. PMID: 38368326; PMCID: PMC10874027.
2. Russotto V, Myatra SN, Laffey JG, et al. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries. JAMA. 2021;325(12):1164-1172.

Bonus book recommendations
3. Heller J. Catch-22. New York, NY: Simon & Schuster; 1961.
4. McGrayne SB. The Theory That Would Not Die. How Bayes’ Rule Cracked The Enigma Code, Hunted Down Russian Submarines & Emerged Triumphant From Two Centuries of Controversy. Yale University Press; 2011.
5. Salsburg D. The Lady Tasting Tea: How Statistics Revolutionized Science In The Twentieth Century. Henry Holt & Company; 2001.


FAST25 | May 19-21, 2025 | Lexington, KY

🔥 FAST25 is back—bigger, bolder, and hotter than ever! 🔥

This isn’t just another conference—a high-energy, immersive experience for pre-hospital and critical care transport pros. Expert-led sessions, hands-on workshops, and unfiltered discussions will take your practice to the next level.

🚀 New for 2025: The Creator Festival – Featuring “Burnt Ones,” a spicy take on Hot Ones, where top EMS creators tackle scorching hot wings while answering the most challenging questions in the industry. Expect live demos, interactive exhibits, and big-name influencers sharing their insight in a way you won’t find anywhere else.

Plus, a killer vendor experience, special guests, catered lunches, and after-hours events that make networking effortless and enjoyable. FAST25 is where it all happens.

📍 Central Bank Center | Lexington, KY
🏨 Hilton Lexington/Downtown (special rates available!)
🎟️ Tickets are limited—grab yours now: flightbridgeed.com/fast25

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