Contributor: Meghan Hurley, MD

Educational Pearls:

• Two main reasons to choose non-traditional RSI

• Anatomically challenging airway

• Physiologically difficult patients: hypoxia, metabolic acidosis, hemodynamic instability

• Ketamine may help patients remain hemodynamically stable

• In critical patients, it is important to consider non-traditional RSI medications to improve outcomes

References

1. Lyon RM, Perkins ZB, Chatterjee D, Lockey DJ, Russell MQ. Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia. Crit Care. 2015;19(1). doi:10.1186/s13054-015-0872-2

2. Merelman AH, Perlmutter MC, Strayer RJ. Alternatives to rapid sequence intubation: Contemporary airway management with ketamine. West J Emerg Med. 2019;20(3):466-471. doi:10.5811/westjem.2019.4.42753

Summarized by Jorge Chalit, OMS1 | Edited by Meg Joyce