A 56-year-old with septic shock requires intubation. He is confused, RR 36, SpO2 89% on high-flow oxygen, BP 82/48 despite fluids and norepinephrine

Question

A 56-year-old with septic shock requires intubation. He is confused, RR 36, SpO2 89% on high-flow oxygen, BP 82/48 despite fluids and norepinephrine has just started. What is the most appropriate next step?

Accepted Answer

Optimise haemodynamics, prepare push-dose vasopressor support, preoxygenate, then perform RSI with a shock-conscious plan

Answer

Delay intubation until vasopressors are discontinued

Answer

Give a large benzodiazepine dose and attempt nasotracheal intubation

Answer

Proceed immediately with standard-dose propofol induction

Answer

Use awake fibreoptic intubation without resuscitation preparation

Physiologically difficult airway — RCPSC EM MCQ

A 56-year-old with septic shock requires intubation. He is confused, RR 36, SpO2 89% on high-flow oxygen, BP 82/48 despite fluids and norepinephrine has just started. What is the most appropriate next step?