Rapid Sequence Intubation Medications

Sedation for Rapid Sequence Intubation

Agent/ClassDose Onset Duration Key Notes

0.3 mg/kg
Etomidate/
given <1 5 to 14 Best all-
imidazole
over 30 to 60 minute minutes around profile
derivative
seconds
Midazolam/
0.1 to 0.3 2 to 3 30 to 60 Amnesia,
benzo-
mg/kg minutes minutes reversible
diazepine
1 to 2
Fentanyl/ <1 30 to 60 Analgesia,
micrograms/kg
opiate minute minutes reversible
IV
Bronchodilation,
amnesia,
Ketamine/ 10 to 30
1 to 2 mg/kg 1 minute analgesia;
dissociative minutes
avoid head injury
(ICP)
1.0 to 2.0 30 to 60 3 to 5 May cause
Propofol
mg/kg seconds minutes hypotension

Paralytics for Rapid Sequence Intubation

Agent/Class Dose Intubation Duration Key Notes

Avoid in
hyperkalemia,
neuromuscular
disease, or ocular
Succinylcholine/2 45 to 60 6 to 12 trauma
depolarizing mg/kg seconds minutes
PEDS: Do not
repeat
dose in small
children
Can also use as
Rocuronium/ an
1.0 45 to 75 25 to 60
non infusion;
mg/kg seconds minutes
depolarizing tachycardia
possible
Vecuronium/ Reversible: few
0.1 90 to 240 25 to 120
non cardiovascular
mg/kg seconds minutes
depolarizing side effects