II. Criteria: Body habitus

  1. Weight: 80 kg

III. Medications: Rapid Sequence Intubation (RSI) and intubation and ventilation

  1. Pretreatment
    1. Lidocaine 120 mg
    2. Fentanyl 250 mcg
  2. Induction (Sedation)
    1. Etomidate 24 mg (most common induction agent)
    2. Ketamine 120 mg (preferred in Asthma or COPD)
    3. Propofol 120 mg (avoid in Hypotension)
    4. Thiopental 250 mg (rarely used for induction)
    5. Midazolam 24 mg (rarely used for induction)
  3. Paralytic
    1. Succinylcholine 120 mg
    2. Rocuronium 80 mg
    3. Vecuronium 8 mg
  4. Sedation Maintenance
    1. Lorazepam 4 mg
  5. Equipment
    1. ET Size cuffed (preferred): 8.0 - 8.5 mm
    2. ET Insertion depth (at lips): 21-23 cm
    3. Laryngoscope Blade: 4 curved blade (Macintosh)
    4. Suction catheter: 14
    5. LMA: 5
    6. Tidal Volume: 400 ml
    7. Breath rate: 12-20
    8. Inspiratory time: 0.8 - 1.0 sec

IV. Protocol: Miscellaneous Equipment

V. Protocol: Fluids

  1. IV Fluid Crystalloid Bolus (20 cc/kg NS, LR): 125 ml
  2. IV Fluid Crystalloid Maintenance: 125 ml/h

VI. Medications: Resuscitation

  1. Cardioversion
    1. First: 50 J
    2. Next: 100 J
  2. Defibrillation
    1. First: 100 J
    2. Next: 120-200 J
  3. Lidocaine
    1. Intravenous (100 mg/5 ml = 2%): 80 mg
    2. Endotracheal (100 mg/5 ml = 2%): 160-240 mg
  4. Epinephrine
    1. Intravenous (1:10,000): 1 mg
    2. Endotracheal (1:1000): 3-10 mg
  5. Atropine
    1. Intravenous (0.1 mg/ml): 0.5-1 mg
    2. Endotracheal (0.4 mg/ml) 2 mg
  6. Naloxone
    1. IV or ET (0.4 mg/ml) 0.4 to 2mg
  7. Adenosine
    1. Initial dose (6 mg/2ml): 6 mg
    2. Next dose (6 mg/2ml): 12 mg
  8. Amiodarone
    1. Intravenous (50 mg/ml): 150-300 mg
  9. Calcium Chloride
    1. Intravenous (100 mg/ml = 10%): 500 to 1000 mg (5-10 ml)
  10. Magnesium Sulfate
    1. Intravenous (5 g/10 ml = 500 mg/ml = 4 meq Mg/ml = 50%) 1-2 g
  11. Sodium Bicarbonate
    1. Intravenous (1 meq/ml = 84 mg/ml = 8.4%) 50 meq (or 1 ampule)

VII. References

  1. Difficult Airway Course
    1. http://www.theairwaysite.com

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