RSI Pharmacology

Question 1

Common RSI Premeds

Answer 1

Atropine, Fentanyl

Question 2

Atropine use, dose, onset

Answer 2

Prevent bradycardia in peds <1 year old, 0.02mg/kg, 2-4 min.

Question 3

Fentanyl use dose onset

Answer 3

For intubating patients with increased ICP, 1-3mcg/kg, 1-3min

Question 4

Common push dose pressors

Answer 4

Epi, Vasopressin, Neosynephrine

Question 5

Push dose Epi use, dose, onset

Answer 5

MAP<65 unrelated to trauma, 5-20mcg, q1-5

Question 6

Vasopressin use, dose, onset

Answer 6

MAP<65, 2units q 2min

Question 7

Neosynephrine use, dose, onset

Answer 7

MAP<65, 50-200mcg q 1-5

Question 8

Shock Index Calculation

Answer 8

PR/SBP; SI>0.9 = High Shock Index

Question 9

8Ps

Answer 9

Preparation
Positioning
Preoxygenate
Pretreat
Paralysis and Induction
Protection and Positioning
Placement and Proof
Post Intubation Management

Question 10

HEAVEN

Answer 10

Hypoxemia-DL
Extremes of Size-VL
Anatomic Disruption-VL
Vomits, Blood, Fluids-DL/VL + SALAD 
Exsanguination-DL
Neck Mobility-VL

Question 11

Common Sedatives

Answer 11

Ketamine, Etomidate

Question 12

Ketamine use, dose, duration, contraindications

Answer 12

RSI w/ high shock index or acute bronchospasm and pediatrics
1-2mg/kg
30min
HTN

Question 13

Etomidate use, dose, onset, duration, contraindications

Answer 13

RSI with HTN
0.3mg/kg
15-45sec
3-12min
Renal insufficiency due to sepsis, hypotension

Question 14

Common Paralyzing Agents

Answer 14

Succinylcholine, Rocuronium, Vecuronium, Nimbex

Question 15

Succinylcholine use, dose, onset, duration, contraindications

Answer 15

Depolarizing agent for RSI  (IDEAL)
1.5-2mg/kg
30-60sec
4-10min
Hyperkalemia, non acute SCI, Crush injury, or burn

Question 16

Rocuronium use, dose, onset, duration

Answer 16

Non-depolarizing agent for RSI
0.6-1.2mg/kg
55-70sec
30-60min

Question 17

Tube sizing for adult males

Answer 17

8.0-9.0

Question 18

Tube sizing for adult females

Answer 18

7.0-8.0

Question 19

Tube sizing for peds > 1 year

Answer 19

(Age + 16)/4

Question 20

Tube placement depth at teeth

Answer 20

3x ETT size

Question 21

Traditional Initial Vent Settings (Vt, RR, I:E, PEEP, FiO2)

Answer 21

8ml/kg
10-12/min
1:2
5cm H2O
100%

Question 22

Lung Protective Initial Vent Settings (Vt, RR, I:E, PEEP, FiO2)

Answer 22

6ml/kg
12-20/min
1:2
2-15cm H2O
100%

Question 23

Obstructive Initial Vent Settings (Vt, RR, I:E, PEEP, FiO2)

Answer 23

6ml/kg
5-8/min
1:4
0-5cm H2O
100%

Question 24

Hypovolemic Initial Vent Settings (Vt, RR, I:E, PEEP, FiO2)

Answer 24

8ml/kg
10-12/min
1:2
0-5cm H2O
100%

Question 25

Common Post Induction Sedatives

Answer 25

Ketamine, Midazolam, Lorazepam

Question 26

Ketamine Post Induction dose

Answer 26

0.5-1 mg/kg q 10min

Question 27

Midazolam Post Induction dose

Answer 27

2.5-5mg q3-5 min

Question 28

Lorazepam Post Induction Dose

Answer 28

1-2mg q 15min

Question 29

Rocuronium Post Induction Dose

Answer 29

1mg/kg

Question 30

Ideal Body Weight formula

Answer 30

(2. 3 x Height greater that 60”) + 50kg for males

(2. 3 x Height greater that 60”) + 45.5kg for females

Question 31

Target Minute Volume

Answer 31

100mL/kg/min

Question 32

Target RR

Answer 32

Minute Volume/ Tidal Volume

Question 33

Target Tidal Volume

Answer 33

6-8mL/kg