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{
    "pk": 12524,
    "title": "Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine",
    "subtitle": null,
    "abstract": "Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of an induction agent and muscle relaxant, is more likely to harm patients who do not allow appropriate preparation and preoxygenation, have concerning airway anatomy, or severe hypoxia, acidemia, or hypotension. Ketamine, a dissociative anesthetic, can be used to facilitate two alternatives to RSI to augment airway safety in these scenarios: delayed sequence intubation – the use of ketamine to allow airway preparation and preoxygenation in the agitated patient; and ketamine-only breathing intubation, in which ketamine is used without a paralytic to facilitate ETI as the patient continues to breathe spontaneously. Ketamine may also provide hemodynamic benefits during standard RSI and is a valuable agent for post-intubation analgesia and sedation. When RSI is not an optimal airway management strategy, ketamine’s unique pharmacology can be harnessed to facilitate alternative approaches that may increase patient safety.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "ketamine"
        },
        {
            "word": "airway"
        },
        {
            "word": "RSI"
        },
        {
            "word": "delayed sequence intubation"
        },
        {
            "word": "ketamine-only breathing intubation"
        }
    ],
    "section": "Critical Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4b27s3ks",
    "frozenauthors": [
        {
            "first_name": "Andrew",
            "middle_name": "H.",
            "last_name": "Merelman",
            "name_suffix": "",
            "institution": "Rocky Vista University College of Osteopathic Medicine, Parker, Colorado",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "C.",
            "last_name": "Perlmutter",
            "name_suffix": "",
            "institution": "University of Minnesota Medical School, Minneapolis, Minnesota; \n\nNorth Memorial Health Ambulance and AirCare, Brooklyn Center, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Reuben",
            "middle_name": "J.",
            "last_name": "Strayer",
            "name_suffix": "",
            "institution": "Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York",
            "department": "None"
        }
    ],
    "date_submitted": "2019-02-14T21:10:32Z",
    "date_accepted": "2019-02-14T21:10:32Z",
    "date_published": "2019-04-26T18:00:56Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/12524/galley/6643/download/"
        }
    ]
}