{
  "abstract": "Introduction Ketamine’s use in Emergency Departments (ED) for rapid sequence intubation (RSI) has risen due to its fast onset, analgesic properties, and haemodynamic stability. It is favoured for its safety profile in unstable patients. This study aimed to examine how frequently ketamine was selected as the primary induction agent for RSI and to compare peri-intubation complication rates between ketamine and other induction agents in the emergency department setting.Method A retrospective audit was conducted using data collected from the Mater Misericordiae University Hospital ED’s airway registry over an eight year period (Aug 2018 to Aug 2025). Data was collected by clinicians contemporaneously after each RSI. Patients excluded were those undergoing intubation during CPR for cardiac arrest, or as part of post return of spontaneous circulation (ROSC) care. Data collected included; age, gender, indication for RSI, induction drugs, pre and post- intubation vitals and complications of RSI. Complications were defined as post-intubation hypotension and post-intubation cardiac arrest.Results 629 intubations were recorded in the ED during the study period. 211 cases were excluded due to missing information or in the cases of intubation during cardiac arrest or for post ROSC care. This left 418 cases for analysis. Ketamine RSI was performed in 128 (31%) with the other 290 (68%) patients undergoing RSI with propofol, midazolam or thiopentone as the primary induction agent. The incidence of post-intubation hypotension in the group given ketamine was 12/128 (9.4%) versus 38/290 (13.2%) in the group given other induction agents. None of the patients who received ketamine experienced post-intubation cardiac arrest, whereas 3 patients (1%) who were administered other induction agents had post-intubation cardiac arrest.Conclusion The use of ketamine as the primary induction agent for rapid sequence intubation (RSI) in the ED appears to be associated with a lower incidence of peri-intubation complications compared to other agents.",
  "authors": [
    {
      "affiliations": [
        "University College Dublin, Ireland",
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Keith Cousins"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Rawan Elhelali"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Osama Hassan"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Cian McDermott"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Fran O’Keeffe"
    },
    {
      "affiliations": [
        "Mater Misericordiae University Hospital, Ireland"
      ],
      "name": "Etimbuk Umana"
    }
  ],
  "title": "#312 Trends in ketamine use for rapid sequence induction. A tertiary emergency department experience",
  "uid": "bbc53bf5-9a11-5a73-87b2-5be7cdecf946"
}