How to Do a Paralytic Only Intubation in a Hypoperfusion Deficit Patient

The highest risk, high perfusion deficit patients are the ones with no mental status. If you do have to go forward with RSI in a really hypo-perfuse patient, dose your sedative low and paralytic high. Whatever drug you give them, whether it be propofol or ketamine, they're going to drop their blood pressure. So it's not about the drug, it's more about the dose.