The Role of Etomidate for Rapid Sequence Intubation in Emergency Medicine: A Systematic Review

Background: Etomidate, a short-acting hypnotic drug, plays a pivotal role in induction for intubation, particularly in emergency settings. Its favourable hemodynamic profile renders it a suitable choice for patients with hemodynamic instability Methods: In this systematic review, we aim to delineate its role in emergency ward settings. Through a systematic search across databases, we identified nine eligible studies for inclusion. We searched the databases of PubMed, Scopus, ProQuest, and Medline (Ovid) from 2004 to 2023 for Randomized Controlled Trials (RCTs) and observational studies in which the study population was referred to the emergency department and received etomidate for Rapid sequence intubation (RSI). Results: These studies collectively underscored the safety and efficacy of etomidate in emergency patients, with its suppressive effects on the adrenal axis deemed clinically insignificant. Conclusions: The rapid onset of action and favourable hemodynamic profile position etomidate as a desirable agent for rapid sequence induction. However, further studies are warranted to strengthen recommendations in this regard.