Core EM - Emergency Medicine Podcast

Episode 110.0 – Advanced RSI Topics

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This week we dive into some advanced topics in RSI including patient positioning and pre-intubation resuscitation.

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Show Notes

Take Home Points

  1. Bed up head elevated position for intubation may reduce intubation related complications.
  2. Patients who are hypotensive or at risk of hypotension should be aggressively resuscitation prior to intubation with fluids and liberal use of pressors
  3. Shock patients would be intubated with decreased induction agent dose, preferably ketamine, and increased paralytic dose.

    4. Bed-Up-Head-Elevated Positioning

    Show Notes

    EMCrit: Podcast 104 – Laryngosocpe as a Murger Weapon (LAMW) Series – Hemodynamic Kills

    Life in the Fastlane: Intubation, hypotension and shock

    Core EM: Bed Up Head Elevated Position for Airway Management Video

    REBEL EM: Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)

    ALiEM: The Dirty Epi Drip: IV Epinephrine When You Need It

    emDocs: Roc Rocks and Sux Sucks! Why Rocuronium is the Agent of Choice for RSI

    Swaminathan A, Mallemat H. Rocuronium Should Be the Default Paralytic in Rapid Sequence Intubation. Ann Emerg Med 2017. PMID: 28601274

    Khandelwal N et al. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Anesth Analg 2016; 122(4): 1101-7. PMID: 26866753


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