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Delayed sequence intubation — RCPSC EM MCQ

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HardResuscitation, procedures, airwayDelayed sequence intubationRCPSC EM

A 24-year-old with severe pneumonia is combative and hypoxic. Oxygen saturation is 82% on non-rebreather, he pulls off preoxygenation devices, and ABG shows severe hypoxaemia. He needs intubation but cannot cooperate. What is the most appropriate initial management?

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Correct answer: B — Use ketamine-assisted preoxygenation with full preparation for RSI

Use ketamine-assisted preoxygenation with full preparation for RSI is correct: the clues indicate Delayed sequence intubation and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian airway emergency practice