JohnClark

Never seen a facial burns, head trauma with the patient clamped down ?

CHF compensating ? Remember the old saying Glasgow < than 8 : intubate ?

Don't get me wrong, RSI can be neccesary in the field. I think that it should be a last resort because of the complications involved, but advanced airway procedures can be neccesary. For example, the madison medics are trained to do surgial airways, and though there use is vanishingly small, I've seen them save people who would've died prior to arrival at the ED without that intervention. Still, it shouldn't be the first club out of the bag, and should be reserved only for those cases where no other treatment is effective.

The only reason to use succs is if you think the case needs to be a little more challenging. I think for the most part RSI is unnecesary in the field, and should be reserved for the ED.

The big trouble with demerol is that it's really fallen out of favor of late with ED folks, and most clinicians will severly underdose it. So if I had to choose I'd ask for morphine.