outlet: St. Emlyn’s Emergency Medicine blog 

For as long as I can remember, emergency and critical care clinicians have debated the optimal induction agent for tracheal intubation in the critically ill. When I started my anaesthetic placements, I used only two drugs for an RSI, Thiopentone and Suxamethonium. Anything else was considered ‘fancy’ amongst the older anaesthetists. The cool kids were using Etomidate/Sux as an alternative, and as I wanted to move with the times, that became my go-to regimen for many years. That changed when Ketamine became the standard here in Virchester, and these days it’s rare that I use anything else, to be honest. I even still occasionally use Etomidate in selected cases (mostly cardioversions), but the logic behind that is not clear (even to me).