Participate in Research at CU Anschutz

Adult

Inclusion Criteria: - Patient is critically ill and undergoing emergency tracheal intubation with sedation in an enrolling unit - Planned procedure is orotracheal intubation using a laryngoscope - Planned operator is a clinician expected to routinely perform tracheal intubation in the participating unit Exclusion Criteria: - Patient is known to be less than 18 years old - Patient is known to be pregnant - Patient is known to be a prisoner - Patient is known to have an allergy to ketamine or etomidate - Patient is presenting to the emergency department with a primary diagnosis of trauma - Patient or LAR declines participation during pre-enrollment opt-out conversation or by wearing opt-out bracelet for the RSI trial - Clinician feels ketamine is required or contraindicated for the optimal care of the patient - Clinician feels etomidate is required or contraindicated for the optimal care of the patient - Clinician feels an induction medication other than ketamine or etomidate is required for the optimal care of the patient - Immediate need for intubation precludes safe performance of study procedures