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A recent study demonstrated that airway complications are more likely as the number of intubation attempts increases (NEJM JW Emerg Med Dec 14 2012). To compare first-pass success for emergency department intubations using etomidate versus ketamine, researchers retrospectively analyzed 5.5 years of data from a prospectively collected intubation database at a single academic center. These agents were used in 93% of intubations.
Among 2098 intubations included in the analysis, etomidate was used in 95%. First-pass success rates did not differ significantly between the etomidate and ketamine groups (77% and 79%). Patients intubated using ketamine were more likely to be female, <18 years old, and intubated for nontraumatic conditions or respirat…