Is Epinephrine a Better Choice for Intubation?

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.

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