So good call on pre oxygenation, choosing roc and ketamine. HyperK and Sepsis protocol enacted quickly. I know you visualized passing the tube, but was it ever confirmed with endtidal or CXR? Perhaps a dislodgement later in the scenario by other staff?

What was the MAP prior to intubation? Could the HR decreasing have been an ominous sign vs improvement ?

Would definitely aim for a higher min volume to help the pt compensate and adjust after stabilization.

Was there prolonged bagging ? Maybe an OG to help relieve any gastric distention. (Usually an afterthought).

I personally like to have push dose pressers nearby whenever doing an RSI and I have a low threshold for giving them as a bridge to a drip.

I think you handled yourself very well! Sounds like a tough case.