II. Criteria: Body habitus
- Weight: 80 kg
III. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation
- Pretreatment
- Induction (Sedation)
- Etomidate 24 mg (most common induction agent)
- Ketamine 120 mg (preferred in Asthma or COPD)
- Propofol 120 mg (avoid in Hypotension)
- Thiopental 250 mg (rarely used for induction)
- Midazolam 24 mg (rarely used for induction)
- Paralytic
- Succinylcholine 120 mg
- Rocuronium 80 mg
- Vecuronium 8 mg
- Sedation Maintenance
- Lorazepam 4 mg
- Equipment
- ET Size cuffed (preferred): 8.0 - 8.5 mm
- ET Insertion depth (at lips): 21-23 cm
- Laryngoscope Blade: 4 curved blade (Macintosh)
- Suction catheter: 14
- LMA: 5
- Tidal Volume: 400 ml
- Breath rate: 12-20
- Inspiratory time: 0.8 - 1.0 sec
IV. Protocol: Miscellaneous Equipment
- Urinary Catheter: 14 F
- Nasogastric Tube: 18 F
- Chest Tube: 32-40 F
V. Protocol: Fluids
- IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 125 ml
- IV Fluid Crystalloid Maintenance: 125 ml/h
VI. Medications: Resuscitation
- Cardioversion
- First: 50 J
- Next: 100 J
-
Defibrillation
- First: 100 J
- Next: 120-200 J
-
Lidocaine
- Intravenous (100 mg/5 ml = 2%): 80 mg
- Endotracheal (100 mg/5 ml = 2%): 160-240 mg
-
Epinephrine
- Intravenous (1:10,000): 1 mg
- Endotracheal (1:1000): 3-10 mg
-
Atropine
- Intravenous (0.1 mg/ml): 0.5-1 mg
- Endotracheal (0.4 mg/ml) 2 mg
-
Naloxone
- IV or ET (0.4 mg/ml) 0.4 to 2mg
-
Adenosine
- Initial dose (6 mg/2ml): 6 mg
- Next dose (6 mg/2ml): 12 mg
-
Amiodarone
- Intravenous (50 mg/ml): 150-300 mg
-
Calcium Chloride
- Intravenous (100 mg/ml = 10%): 500 to 1000 mg (5-10 ml)
-
Magnesium Sulfate
- Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 1-2 g
-
Sodium Bicarbonate
- Intravenous (1 meq/ml = 84 mg/ml = 8.4%) 50 meq (or 1 ampule)
VII. References
- Difficult Airway Course