Certified Transport Registered Nurse Certification Practice Exam

What is the drug of choice for sedation during Rapid Sequence Intubation (RSI)?

1. Propofol

2. Etomidate

3. Midazolam

4. Fentanyl

The correct answer is: Etomidate

The drug of choice for sedation during Rapid Sequence Intubation (RSI) is Etomidate. This medication is widely preferred in the context of RSI primarily due to its unique pharmacological profile. Etomidate is an ultra-short acting, non-barbiturate hypnotic that facilitates rapid onset sedation without significant cardiovascular instability. This is critical in emergency situations where patients often present with compromised hemodynamics. Unlike many sedatives, Etomidate does not depress the respiratory drive excessively and is less likely to cause hypotension or respiratory depression, making it a safer option in unstable patients. Additionally, Etomidate has a minimal effect on the cardiovascular system, preserving hemodynamic stability, which is crucial in patients who may already be critically ill or hypotensive when they require intubation. The rapid onset of action allows for quick sedative effects, enabling successful and timely intubation. In contexts where cardiovascular considerations are paramount, the benefits of Etomidate’s use during RSI become even more significant, reinforcing its status as the preferred agent for achieving procedural sedation in these scenarios.