Calling the RSI on a crashing asthmatic

Had a 24-year-old at 03:10 sat 86% on NRB, still tiring after stacked nebs and steroids — at what point are you moving to mag/IM epi versus committing to RSI, and how do your ED protocols frame that decision in real time? I’m revisiting our pathway and want to compare triggers you use under pressure…

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌⁠​​‌‍‍​‌⁠‍‌‌⁠​⁠‌‍‍‌‌‍​⁠‌‍‍‌‌‍​‌‌‍⁠‍‌‍​‌‌⁠​⁠‌⁠​⁠‌‍‍‌‌⁠​⁠‌⁠‌​‌‍​‌‌‍⁠‍‌⁠‌​​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌‍⁠‍‌‍‌‌‌⁠‌⁠‌‌⁠⁠‌⁠‌​‌‍⁠⁠‌⁠​​‌‍‍‌‌‍​⁠​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​‍​‍‌‍⁠‍‌‍‌‌‌⁠‌⁠​‍​‍​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​‌​⁠​​​⁠‌⁠​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍​‍⁠‌‌‍​‍‌⁠​​‌​‍⁠‌​​‌‌‌‌⁠‌‍‌⁠‌⁠​‍‌‍‌‌‌‌‌‍‌‌​‌‌‍‌‌​⁠‌‌‌​​‌​⁠‍​‌⁠​‍​‍​‍‌⁠⁠‌​​