What is a common induction agent that may cause hypotension during RSI, and what is its typical dose?

• A. Etomidate 0.3 mg/kg IV.
• B. Ketamine 1-2 mg/kg IV.
• C. Rocuronium 0.6-1.2 mg/kg IV.
• D. Propofol 1-2 mg/kg IV (watch for hypotension).

Answer: (D)

Propofol is the induction agent that commonly carries a risk of hypotension during rapid sequence intubation because it causes peripheral vasodilation and some degree of myocardial depression, which can significantly lower blood pressure in patients who are often already hemodynamically unstable. The typical dose to induce anesthesia quickly is 1-2 mg/kg given IV, administered rapidly to achieve rapid loss of consciousness for intubation. In contrast, etomidate is known for relatively stable hemodynamics, ketamine tends to raise blood pressure, and rocuronium is a paralytic rather than an induction agent, so it’s not used to induce unconsciousness. Thus, propofol at 1-2 mg/kg IV best fits the description.