Etomidate

We also use etomidate for almost all of our RSI intubations. We have had great success for the same of the above mentioned reasons. A couple of comments- It is very short acting. each 0.1mg/kg IVP produces approximately 100seconds of hypnosis(Miller, Anesthesia Volume 1,2000). The standard 0.3mg/kg would give you around 5 minutes.I only point this out to remember that if you have a problem during RSI and need to take some time you may be intubating a non-sedated patient. On the plus side, studies with 0.3mg/kg up to 0.6mg/kg IVP produced no change in the HR,MAP, PCWP, CVP, SV, and SVR in heart healthy adults and minimal change in cardiac disease patients (same reference). The primary action of etomidate is hypnosis so as others have mentioned you will need to follow with the appropriate longer acting benzo for sedation maintenance. As also mentioned side effects include myoclonis, and vomiting.