![]() Using a pro-con debate style, the following manuscript discusses the use of ketamine versus etomidate in RSI.Īdrenal suppression airway management etomidate ketamine rapid sequence intubation. Hemodynamic Effects of Ketamine Versus Etomidate for Prehospital Rapid Sequence Intubation. Ketamine (Ketalar 1 to 2 mg/kg IV over 1 to 2 min- utes) is a dissociative. Stanke L, Nakajima S, Zimmerman LH, Collopy K, Fales C, Powers W. Oro-tracheal rapid sequence induction is the method of choice for securing the airway in paediatric major trauma, however effective pre-oxygenation may not be. Abstract: Pediatric rapid sequence intubation is a skill of great importance. However, experience and clinical investigations have raised safety concerns associated with both etomidate and ketamine. Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting. Ketamine and etomidate, both of which provide effective sedation with limited effects on hemodynamic function, have become increasingly popular as induction agents for RSI. Burn patients with airway involvement and inevitable airway loss. Closed head injury or major stroke with unconsciousness. Trauma patients with significant facial trauma and poor airway control. 6 Tracheal intubation is indicated in the following clinical scenarios: 1) respiratory failure due to inadequate oxygenation 2) respiratory failure due to inadequate ventilation 3) lack of neuromuscular respiratory drive. Trauma patients with Glasgow Coma Scale of nine or less with gag reflex. Rapid sequence intubation (RSI) is defined as the simultaneous administration of a sedative agent for emergent intubation. A significant safety concern regarding sedatives is the risk of hypotension and cardiovascular collapse, especially in critically ill patients or those with pre-existing comorbid conditions. RAPID SEQUENCE INTUBATION Indications: 1. Along with a rapid acting neuromuscular blocking agent, sedation is an essential element of RSI. traditionally uncuffed until age 8, then cuffed (a ‘one-size smaller’ cuffed tube can be used in children <8 years) leak. Once patient fasciculated/ paralysed perform rapid laryngoscopy with placement of a endotracheal tube. Rapid sequence intubation (RSI) is generally used in emergency airway management to protect the airway from passive regurgitation of gastric contents. Suxamethonium 1-2mg/kg IV (2mg/kg for neonates, and 1mg/kg children) OR rocuronium 1.2mg/kg IV. Airway control with endotracheal intubation is frequently necessary. ![]() When caring for critically ill children, airway management remains a primary determinant of the eventual outcome. ![]()
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