You are caring for a 6yo oncology patient presenting in septic shock. Although he is oxygenating and ventilating well at this time, you plan to intubate him to reduce his metabolic work. The most important pre- treatment before rapid sequence intubation (RSI) is:
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September 19, 2017 at 7:53 am
E. Fluids, as intubation and mechanical ventilation may affect hemodynamics adversely
The medications given for RSI may exacerbate hypotension. Additionally, positive pressure ventilation results in decreased venous return, which can further exacerbate hypotension. Atropine is no longer routine recommended for pediatric RSI (see discussion at PED EM Morsels http://pedemmorsels.com/atropine-needed-rsi/)