Survey of Pharmacologic Agents Used during Rapid Sequence Intubation of Traumatically Injured Patients

The Eastern Association for the Surgery of Trauma RSI Guidelines have not been updated since 2012 and do not provide specific recommendations regarding pharmacologic agents for RSI.1 Alternatively, the Clinical Practice Guideline for Trauma Airway Management released by the United States Joint Trauma System was most recently updated in 2017 and recommends ketamine as the agent of choice for induction of RSI but does not specify one paralytic agent as first-line compared with others.2 Published in 2018, the 10th edition of Advanced Trauma Life Support (ATLS) recommends "an induction agent (e.g., etomidate) or sedative" plus succinylcholine for "drug-assisted intubation. [...]given the low response rate, we were unable to perform any statistical comparisons across groups in the attempt to identify trends in specific medication usage. [...]there are no previous studies of similar design to compare our results against, so we were unable to determine any changes in practice over time.