An intubated 33-year-old man is agitated and the ETA to hospital is 15 minutes. What is the most appropriate action now?

• A. Provide verbal reassurance only
• B. Administer a sedative medication
• C. Administer a paralytic
• D. Prepare for rapid sequence induction

Answer: (B)

Maintaining the airway and ventilation during transport means calm, controlled sedation when an intubated patient becomes agitated. Agitation can cause the endotracheal tube to be displaced, worsen ventilator synchrony, and lead to hypoxia or airway complications before arrival. Providing a sedative quickly settles the patient’s agitation and stabilizes ventilation, which is why administering a sedative medication is the best choice now.

Verbal reassurance alone is unlikely to control agitation in the short time frame needed. A paralytic would immobilize the patient without ensuring adequate sedation, which is dangerous when the airway is already secured. Preparing for rapid sequence induction implies re-establishing the airway, which isn’t indicated here since the tube is in place and ventilation is ongoing.