Emergency Adult Dosing 80 kilogram

Aka: Emergency Adult Dosing 80 kilogram, Emergency Drug Dosing in Morbid Obesity

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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

  1. Urinary Catheter: 14 F
  2. Nasogastric Tube: 18 F
  3. Chest Tube: 32-40 F

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. Medications: Emergency Drug Dosing in Morbid Obesity

  1. Drugs to dose by total body weight
    1. Succinylcholine
    2. Propofol maintenance dosing
    3. Midazolam induction dosing
    4. Lorazepam induction dosing
  2. Drugs to dose by Ideal Body Weight (IBW)
    1. Rocuronium
    2. Vecuronium
    3. Cisatracurium
    4. Morphine
    5. Ketamine
    6. Midazolam maintenance
    7. Lorazepam maintenance
  3. Drugs to dose by Lean Body Weight (LBW)
    1. Fentanyl
    2. Propofol induction dosing
    3. Etomidate
    4. Dexmedetomidine
  4. References
    1. (2025) Airway Management, Hospital Procedures Course

VIII. References

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

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