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If you are doing this to present an argument to your medical director, I recommend you tread very lightly. A lot of the latest research looks bad for prehospital RSI, and intubation in general. Is there any reason they are using versed over etomidate? Etomidate is quicker on/quicker off if things go bad. From personal experience, it works much better for sedation anyway. If you adequately sedate there is no reason to complicate things by adding more meds such as an analgesic. I'm a simple person and like to keep things simple. If someone is being RSI'd they are sick to begin with. You are now going to throw a bunch of meds at them. If they deteriorate, how will you be able to decide if it is from there underlying disease versus medication issues? I'm also not a big fan of pharmacologically assisted intubation. You either go all in, or not at all (yes, I realize there are exception, but as a general rule). If they are going to have you sedate and quasi-paralyze, why not just go all the way and make sure it is done correctly to optimize your chances of success? In that case, the sux would be a much better option as it is quick on/quick off. There are a few instances where it may not be the best option but more often it will be fine.

Plus 1 FM65.... I have a cat with three legs.....but that is another story. Seriously, I think you post is honest and well stated. Thank you... AM 571