Rapid Sequence Intubation in Head Trauma - Traumatic Brain Injury on Adults: A Literature Review

Deciding on appropriate drug administration for traumatic brain injury (TBI) patients undergoing intubation can be scary and confusing. Pre - treatment with lidocaine and/or vecuronium is no longer recommended; however, high doses of fentanyl can be used to help blunt the sympathetic stimulation of intubation. Induction with etomidate is recommended; However, ketamine may be considered in appropriate patient populations, such as hypotension. Paralysis can be performed with succinylcholine or rocuronium, with a warning that rocuronium may cause delays in proper neurologic examination because: prolonged paralysis. Recommendations for continuous post - intubation sedation including the combination of propofol and fentanyl in normotensive/hypertensive patient population. The combination of midazolam and fentanyl or ketamine alone may be considered ina hypotensive patient.