Rapid Sequence Intubation (RSI) - Analgesics Flashcards
Hypnotic (sleep producing), analgesic (pain relieving), amnesic (short term memory loss) drug
Ketamine
Ketamine trade name
Ketalar
Ketamine dosage (varies based on intended use and protocol)
1 mg/kg IV
2 mg/kg IM
Ketamine onset
45-60 sec
Ketamine duration
11-17 min
Ketamine is used to stop
pain impulses (NMB’s and Etomidate do not control pain)
This medication is also a potent bronchodilator and is preferred in RSI of asthmatic patients
Ketamine
Ketamine can do what to secretions in airway?
increase
In cases of laryngospasm confirming increased secretions due to Ketamine, give:
- 01 mg/kg IV Atropine or
0. 3 mg IV Scopolamine SLOWLY
Hallucinations can be caused by
Ketamine upon waking
Morphine is an opioid
analgesic
Morphine dose based on intended use and local protocol
2 mg IV/IM/IO for mild pain control Q4H PRN
5 mg IV/IM/IO for moderate pain control Q4H PRN
Morphine onset
within minutes
Morphine duration
2-3 hours
Morphine and fentanyl often require antiemetics and IV is preferred route:
Zofran 4mg IV/IO/IM
Phenergan 25 mg IV/IO/Deep IM
Reversal agent for Morphine and Fentanyl
Naloxone (Narcan) 0.4 - 2 mg IV/IM/ETT
Fentanyl is an opioid angalgesic _____ X more powerful than morphine
100
Fentanyl dose is based on intended use and local protocol
50-100 mcg IV Q2H PRN
Lozenge form of Fentanyl (Actiq) dose
400 or 800 mcg
Actiq lozenge is only FDA approved for pain control in cancer patients, trauma use is
off-label
Fentanyl onset
1-2 minutes
Fentanyl duration
45-60 min
Avoid fentanyl in patients with
Increased ICP
hypoventilations (can cause chest wall rigidity)
Hypotension
Bradycardia
