Info
🌱 來自: critical airway
pharmacology-of-critical airway
Pretreatment
- 3-5 mins prior to intubation for High ICP
- Fentanyl 3 mcg/kg
- Lidocaine 1.5 mg/kg
Push dose Epinephrine
- 1:100000 Epi (10 mcg/mL) 0.5-2 mL g 1-5min
- 1:1000 Epi 1mL. + 9 mL NS ⇒ 1:10000 Epi
- 1:10000 Epi 1mL + 9 mL NS⇒1:100000 Epi
Hypotensive patients or patients with shock index > 0.8
- Volume load 10-20 ml/kg,
- Push dose Epinephrine.
- 1/4 to 1/2 dose of induction agent: Etomidate or Ketamine.
- Higher dose of paralysis: Succinylcholine or Rocuronium
Contraindication to Succinylcholine
- Malignant hyperthermia history
- Strokes with hemiparesis > 72 hours
- ICU stay > 2 weeks
- Burns/trauma > 72 hours o NMJ disease
- Myopathies/Muscular dystrophies
- Hyperkalaemia(known or suspected)
- Guillain-Barre syndrome
- Penetrating eye injury and acute glaucoma
RSI Drug (1.5 Rule)
| Drug | Dose | Onset | Duration |
|---|---|---|---|
| Etomidate | 0.3 mg/kg | < 30 s | 5-10 min |
| Ketamine | 1-2 mg/kg | 30-60 s | 15-20 min |
| Propofol | 1-2 mg/kg | < 30 s | 5-10 min |
| Succinylcholine | 1-2 mg/kg | < 1 min | 5-10 min |
| Rocuronium | 1-1.2 mg/kg | 1-1.5 min | 40-60 min |
| Sugammadex | 16 mg/kg | 2 min | NMBA reversal |
Note: “NMBA reversal” in the duration column for Sugammadex indicates that it is used for the reversal of neuromuscular blocking agents (NMBAs), rather than having a specific duration of action like the other drugs listed.