Rapid Sequence Intubation for Hypotension and Shock.





  • Preparation—isotonic fluid boluses or blood products
  • Preoxygenation (as possible)—100% oxygen for 3 min or eight vital capacity breaths
  • Pretreatment—phenylephrine hydrochloride (Neosynephrine), 50–100 μg IV push (if still hypotensive after IVFs or blood)
  • Paralysis with induction:
    • Ketamine, 0.5–0.75 mg/kg OR
    • Etomidate, 0.1–0.15 mg/kg
    • Succinylcholine, 1.5 mg/kg IV

  • Laryngoscopy with intubation
  • End-tidal carbon dioxide confirmation
  • Postintubation management—continued volume resuscitation

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