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Emergency Medical Minute


Apr 24, 2023

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


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