sedation/rsi Flashcards
etomidate(amidate)
description: etomidate is a ultra short acting nonbarbiturate hypnotic with no analgesic effects and limited cardiovascular and respiratory effects.
indications:induce sedation for rapid sequence intubation.
contraindications:none
precautions:head injury if no paralytics used, marked hypotension, severe asthma, or severe cardiovascular disease.
dosage/route: 0.1 to 0.3 mg/kg iv over 15to 30 sec.
pedi:children>10years same as adults.
HALOPERIDOL(HALDOL)/ANTIPSYCHOTIC
Description: Haloperidol is believed to block dopamine receptors in the brain associated with mood and behavior, is a potent antiemetic, and impairs temperature regulation.
Indications: acute psychotic episodes.
Contraindications: parkinson’s disease, seizure disorders, coma, alchol depression, cns depression, and thyrotoxicosis, and with other sedatives.
Precautions: Orthostatic hypotension.
Dose/Route: 2-5 mg IM. normally mixed with benadryl to avoid EPS reactions.
PANCURONIUM (PAVULON)/Nondepolarizing neuromuscular blocker
Description: Pancuronium is a nondepolarizing neuromuscular blocker that causes paralysis without bronchospasm or hypotension.
Indications: To facilitate endotracheal intubation.
Contraindications: Tachycardia.
Dose/route: 0.04-0.1 mg/kg IV.
Pedi: same as adult.
SUCCINYLCHOLINE(ANECTINE)/Depolarizing neuromuscular blocker.
Description: Succinylcholine is an ultra short acting depolarizing neuromuscular blocker.
Indications: facilitated endotracheal intubation.
Contraindications: Family history of malignant hyperthermia, penetrating eye injury, narrow angle glaucoma, hyperkalemia, crush injury, burns over 24 hours, mystina gravitas, ms, als.
Precautions: Severe burns, spinal cord injuries.
Dose/route: 1-1.5 mg/kg IV/IM
pedi: 1-2 mg/kg iv/im
VECURONIUM(NORCURON)/nondepolarizing skeletal muscle relaxant
Description: Vecuronium is a nondepolarizing skeletal muscle relaxant similar to pancuronium with minimal cardiovascular effects.
Indications: facilitated endotracheal intubation.
Contraindications: NONE
Precautions: Hepatic or renal impairment, impaired fluid and electrolyte or acid/base balance, severe obesity, myasthenia gravis, elderly, debilitated patients, or malignant hyperthermia.
Dose/route: 0.1 mg/kg IV
Pedi: same as adult
ROCURONIUM BROMIDE(ZEMURON)/Nondepolarizing neuromuscular blocker
Description: Rocuronium antagonizes acetylcholine at the motor end plate producing skeletal muscle paralysis.
Indications: Rapid sequence intubation (RSI)
Precautions/side effects: Bronchospasm, wheezing, rhonchi, respiratory depression, apnea, dysrhythmias, tachycardia.
Dose/route: 0.6-1.2 mg/kg IV/IO
Pedi: same as adult.
PROPOFOL(DIPRIVAN) Sedative hypnotic
Description: Propofol produces a rapid and breif state of general anesthesia.
Indications: Anesthesia induction, anesthesia maintenance, sedation for mechanically ventilated patients.
Contraindications: Hypovolemia, known sensitivity including soybean oil, peanuts and eggs.
Precautions/side effects: Seizure, apnea,dysrhthmias, asystole, hypotension, hypertension.
Dose/route: Induction dose: 1.5-3 mg/kg IV/IO. maintenance infusion: 25-75 ug/kg/min IV/IO.
Pedi: Induction dose: 2.5-3.5 mg/kg IV/IO. maintenance infusion 125-300 ug/kg/min IV/IO
