Ketamine Versus Etomidate for Rapid Sequence Intubation

Ketamine Versus Etomidate for Sedation of Emergency Department Patients During Rapid Sequence Intubation

The purpose of this study is to compare the effectiveness and safety of ketamine and etomidate during rapid sequence intubation (RSI).

This study is a randomized controlled trial of etomidate versus ketamine during rapid sequence intubation (RSI). RSI refers to the process by which patients who require emergency airway management undergo sedation and paralysis prior to insertion of an endotracheal tube(airway tube). Patients who require intubation will be randomized to have intubation performed with either ketamine or etomidate. All other care will be at the discretion of the treating physicians. The purpose of this study is to compare the efficacy and safety of ketamine and etomidate during rapid sequence intubation.

Inclusion Criteria:

• 18 years of age
• Undergoing rapid sequence intubation (RSI) in the Emergency Department

Exclusion Criteria:

• Known contraindication to ketamine or etomidate
• Patient has a condition in which an increase in heart rate or blood pressure would be hazardous, as judged by the treating physician
• Patient is known or suspected of having increased intracranial pressure, based on the history and physical examination performed by the treating physician.
• Females of child-bearing age, defined as 18-50 years, who do not have a documented pregnancy test in this institution confirming that they are not pregnant or who do not have a confirmed surgical procedure preventing pregnancy, i.e., tubal ligation, hysterectomy. The timing of the pregnancy test at which the investigative team will consider a subject to be non-pregnant is a documented negative test during current hospitalization or upon direct transfer from outside institution during current illness.
• Patient declines participation in the trial by wearing a bracelet marked "KvE declined"
• Prisoner