RSI Drugs

Question 1

4 different phases of RSI drugs?

Answer 1

1. Pretreatment
2. Sedation agents
3. Paralytics
4. Post-intubation sedation

Question 2

During RSI if patient is obtunded or in shock you should?

Answer 2

Give 1/2 sedation dose and 2x the paralytic

Question 3

Pretreatment drugs (RSI)

Answer 3

Fentanyl
Atropine

Question 4

Fentanyl dose (pretreatment RSI)

Answer 4

1-3 mcg/kg

Question 5

Atropine dose (pretreatment RSI)

Answer 5

0.02 mg/kg

Question 6

Sedation agent (RSI)

Answer 6

Etomidate
Ketamine
Propofol
Fentanyl

Question 7

Etomidate dose (sedation RSI)

Answer 7

0.3 mg/kg

Question 8

Ketamine (sedation RSI)

Answer 8

1-2mg/kg IV
2-4mg/kg IM

Question 9

Propofol (sedation RSI)

Answer 9

0.5-2mg/kg

Question 10

Fentanyl (sedation RSI)

Answer 10

3-8mcg/kg

Question 11

Paralytic drugs (RSI)

Answer 11

Succinylcholine
Rocuronium
Vecuronium
Cisatracurium (Nimbex)

Question 12

When to use cisatracurium (nimbex) (paralytic RSI)

Answer 12

For liver and or renal failure patients

Question 13

Succinylcholine dose (paralytic RSI)

Answer 13

1-1.5mg/kg

Question 14

Rocuronium dose (paralytic RSI)

Answer 14

0.6-1.2 mg/kg

Question 15

Reversal agent for rocuronium?

Answer 15

Sugammadex 2-16 mg/kg

Question 16

Vecuronium dose (paralytic RSI)

Answer 16

0.1mg/kg

Question 17

Cisatracurium (nimbex) dose (paralytic RSI)

Answer 17

0.15-0.2mg/kg IV

Question 18

Post intubation sedation medications

Answer 18

Propofol
Versed
Ketamine
Fenanyl
Dexmedetomidine (precedex)

Question 19

Propofol dose (Post intubation sedation)

Answer 19

5-50 mcg/kg/min drip
- 20mcg/kg/min common starting rate
- May require 20-40mg boluses until drip set up
BOLUS is mg, the rest are mcg

Question 20

Versed dose (Post intubation sedation)

Answer 20

10-50mcg/kg slow IV load
The
20-100mcg/kg/hr drip

Question 21

Ketamine dose (Post intubation sedation)

Answer 21

0.05-0.5 mg/kg/hr

Question 22

Fentanyl dose (Post intubation sedation)

Answer 22

1-2mcg/kg/hr

Question 23

Dexmedetomidine (precedex) dose (Post intubation sedation)

Answer 23

0.2-1.5mcg/kg/hr

Question 24

procedural sedation (rule of thumb)

Answer 24

Generally 1/2 your RSI dose given in divided doses until desired effect

Question 25

Procedural sedation meds

Answer 25

Ketamine
Etomidate
Fentanyl
Midazolam
Propofol

Question 26

Ketamine dose (procedural sedation)

Answer 26

1-2mg/kg IV

Question 27

Etomidate dose (procedural sedation)

Answer 27

0.15mg/kg
- quick on and off - great for cardioversion

Question 28

Fentanyl dose (procedural sedation)

Answer 28

2-3mcg/kg IV
1-2mcg/kg IN (1/2 per nostril)

Question 29

Midazolam dose (procedural sedation)

Answer 29

0.02-0.1 mg/kg IV
0.2-0.3 mg/kg IN (often used in peds)

Question 30

Propofol dose (procedural sedation)

Answer 30

0.5-1mg/kg IV

Question 31

Opioid overdose meds

Answer 31

Naloxone (narcan)

Question 32

Naloxone dose for adults

Answer 32

0.4mg initial
- increase to 2mg if inadequate response
- consider pretreating w antiemetic

Question 33

Naloxone (narcan) peadiatrics dose

Answer 33

0.01mg/kg initial
- Repeat at 0.1mg/kg if inadequate response

Question 34

Naloxone (narcan) drip rate

Answer 34

2/3 “wake up” dose/hr (.26-1.32mg/hr and .0066-.066mg/hr)
“Wake up dose”:
- adult 0.4-2mg
- peds 0.01-0.1mg/kg