RSI Pharm

Question 1

Midazolam (Versed)

Answer 1

●Dose: 0.05-0.1mg/kg IV (0.5-5mg)

not usually recommended for RSI, some practitioners use low doses of midazolam and fentanyl for RSI of shocked patients

Question 2

Diazepam (Valium)

Answer 2

●Dose: 2-10mg PO/IV

not usually recommended for RSI, some practitioners use low doses of midazolam and fentanyl for RSI of shocked patients

Question 3

Ketamine (Ketalar)

Answer 3

●Dose: 1-2 mg/kg IV/IO slow push, followed by 0.5-1mg/kg prn

● Use: any RSI, especially if hemodynamically unstable (OK in TBI, does not
increase ICP despite traditional dogma) or if reactive airways disease (causes bronchodilation)
● Drawbacks: increased secretions, caution in cardiovascular disease (hypertension, tachycardia), laryngospasm (rare),

Question 4

Fentanyl (Sublimaze)

Answer 4

●Dose: 0.5-2 mcg/kg IV slow IV push for pain
3 mcg/kg IV slow IV push for pre-treatment prior to RSI

●Drawbacks: respiratory depression, apnea, hypotension, slow onset, nausea and vomiting, muscular rigidity in high induction doses, bradycardia

Rarely used for induction

Question 5

Etomidate (Amidate)

Answer 5

●Dose: 0.3mg / kg IV / IO push

●Drawbacks: adrenal suppression, myoclonus, pain on injection

Question 6

Depolarizing paralytic

Answer 6

succinylcholine

Question 7

Non depolarizing paralytic

Answer 7

Rocuronium, vecuronium

Question 8

Succinylcholine

Answer 8

● Dose: 1-1.5 mg / kg IV / IO push
● Drawbacks: numerous contraindications
Bradycardia, hyperkalemia, fasciculations

Question 9

Rocuronium (Zemuron)

Answer 9

● Dose: 0.6-1.2 mg / kg IV / IO push
● Drawbacks: allergy (Rare)

can be reversed by sugammadexv

Question 10

Vecuronium (Norcuron)

Answer 10

● Dose: 0.1mg / kg IV/IO push; reconstitute supplied powder with 10ml NS
● Drawbacks: allergy (rare), slow onset, long duration

can be reversed by sugammadex