What drugs are used in rapid sequence intubation?
[4] Common sedative agents used during rapid sequence intubation include etomidate, ketamine, and propofol. Commonly used neuromuscular blocking agents are succinylcholine and rocuronium. Certain induction agents and paralytic drugs may be more beneficial than others in certain clinical situations.
How do you do a rapid sequence induction?
A pre-calculated dose of induction agent is administered, followed immediately by a neuromuscular blocking agent. Cricoid pressure (at 20–40 N or 2–4 kg) is applied before loss of consciousness. After the jaw has relaxed and succinylcholine-associated fasciculations have ceased, the trachea is intubated.
Is propofol used in RSI?
When used for RSI, propofol administration was associated with satisfactory intubating conditions that were comparable to those seen with thiopental and etomidate. Blood pressure reductions were seen in both DCC and RSI studies.
When is rapid sequence intubation indicated?
Rapid sequence intubation is indicated for a patient in acute respiratory failure due to poor oxygenation or ventilation, and for a patient that cannot protect their airway due to altered mental status. RSI may also be used in a patient with an acute upper gastrointestinal bleed with a high risk of aspiration.
What does succinylcholine do to potassium?
Succinylcholine causes for a transient elevation in potassium by 0.5 – 1.0 mEq in the first 3-5 minutes following administration. This is not of grave concern for most patients as their potassium level is likely normal with hopefully normal kidney function.
Is etomidate give before succinylcholine?
Patients receiving etomidate generally return to baseline cognitive and neuromuscular status within five minutes. If the patient is unable to be ventilated and succinylcholine is available, it should be administered immediately at the RSI dose of 1.5mg/kg.
Does rocuronium increase potassium?
Background: Succinylcholine provides rapid onset of neuromuscular blockade and short duration of action, but its administration may be associated with hyperkalemia. Rocuronium is not known to increase potassium concentration, has fast onset of activity, and can be rapidly reversed by sugammadex.