Catoire P et al., Sequence of administration of anesthetic agents during rapid sequence induction for emergency intubation: a French survey on current practices, Eur J Emerg Med, 2023

Catoire P, Roussel M, Teissandier D

Eur J Emerg Med 2023 Oct. doi: 10.1097/MEJ.0000000000001085

First words

Endotracheal intubation is a common procedure in emergency medicine, required for airway management. Risks of both failure at the first attempt and of complications are high, estimated around 30% for first pass failure and between 20 and 45% for severe complications.

Except in situations of cardiac arrest, the procedure includes a rapid sequence induction (RSI) combining a sedative agent and a paralytic agent. However, both French and American recommendations do not specify a preferred agent, suggesting ketamine and etomidate for the hypnotic agent, and succinylcholine or rocuronium for the curare. Several recent trials have failed to identify any superiority of one sedative or paralytic agent over the other (…)