Outlet: EM-RAP 

Ketamine or etomidate for tracheal intubation of critically ill adults Casey JD, Seitz KP, Driver BE, et al. N Engl J Med. Published online December 9, 2025. doi:10.1056/NEJMoa2511420

SUMMARY:

• Many articles have compared etomidate vs ketamine as induction agents for rapid sequence intubation (RSI), and the retrospective and prospective trial data have shown mixed results. A major concern is etomidate’s effects on the adrenal glands. Laboratory testing has indicated that etomidate affects markers of adrenal function, even when administered as a single dose; however, real effects on clinical outcomes have been much more difficult to demonstrate. We have recently covered a massive retrospective study on the topic, which reported a 3% absolute increase in mortality with etomidate use in a 40,000-patient outcome cohort, but this finding was almost certainly influenced by unmeasured but highly relevant confounders.

Outlet: Pharmacy to Dose: The Critical Care Podcast  

Youtube: https://youtu.be/uWx3tYZ_mfs    
Apple: https://podcasts.apple.com/us/podcast/pharmacy-to-dose-the-critical-care-podcast/id1479298456?i=1000746033779   
Spotify: https://open.spotify.com/episode/5R9a9Es0lggximB2iC6Gw0?si=ca7eca2d4edf455f   

Outlet: The Skeptics Guide to Emergency Medicine Podcast 

Reference:  Casey et al. RSI Investigators and the Pragmatic Critical Care Research Group. Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. NEJM. 2025 Dec

Guest Skeptic: Dr. Scott Weingart is an ED Intensivist from New York. He did fellowships in Trauma, Surgical Critical Care, and ECMO. Scott is best known for talking to himself about Resuscitation and Critical Care on the podcast EMCrit, which has been downloaded more than 50 million times.

Outlet: ECC Podcast 

outlet: Pharmacy – Emergency Medicine Deep Dive Podcast 

In this episode, we dive into the RSI Trial, a groundbreaking study comparing ketamine and etomidate for rapid sequence intubation in critically ill adults. While the trial found no difference in 28-day mortality between the two drugs, it revealed that ketamine was linked to more episodes of cardiovascular collapse, largely due to increased vasopressor use. We unpack the clinical debate around this finding, exploring whether it reflects true hemodynamic instability or the effects of ketamine’s stronger analgesia. Tune in as we explore what this means for critical care practice and challenge the assumption that ketamine is always the safer choice.

Outlet: The World’s Okayest Medic Podcast 

outlet: EmCrit podcast 

Just off embargo: The RSI Trial

Ketamine vs. Etomidate for the induction of critically ill patients for RSI

I am lucky enough to be joined by lead authors:

Jonathan Casey

and

Brian Driver

We start our Critical Care Reviews Down Under coverage with RSI talking with the first author of the “Ketamine versus Etomidate for Adults Receiving Emergency Endotrachael Intubation”, Jonathan Casey! We will pick up the rest of our CCR Down Under Coverage after the holiday break!

outlet: ICU-Ed and Todd-Cast podcast 

Outlet: Hennepin airway podcast 

outlet: Flightbridge ED podcast 

Episode 40! In this special episode releasing at the conclusion of the PREOXI presentation at the Critical Care Reviews 2024 conference in Belfast, Ireland – we discuss the recently published PREOXI trial evaluating NIV vs facemask as pre-oxygenation for emergent endotracheal intubation. Kevin Gibbs, the first author and presenter at the conference, is our special guest.  

Drs Brian Driver and Matt Prekker join Rob Mac Sweeney to address some of the questions and comments that arose following the presentation and publication of the BOUGIE trial, comparing the use of a stylet with that of a bougie in emergency intubation.