A 45-year-old patient with a closed head injury and a blood pressure of 130/80 mmHg requires rapid sequence intubation (RSI) in the emergency department. Which medication is the most appropriate induction agent for this procedure?
Lorazepam
Propofol
Diazepam
Etomidate
Etomidate is considered a first-line induction agent for rapid sequence intubation (RSI), especially in patients with traumatic brain injury, due to its favorable hemodynamic profile and minimal effects on cerebral perfusion pressure. It has a rapid onset and short duration of action, which are ideal characteristics for RSI. Diazepam and lorazepam are not recommended for RSI because of their slower onset, prolonged duration of action, and potential for respiratory depression. Propofol is also a rapid-acting agent but is known to cause vasodilation and hypotension, which can be detrimental to a patient with a head injury by reducing cerebral perfusion pressure.
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