1. Drugs to Assist in Intubation Sara Park 11.18.11

2. Rapid Sequence Induction (RSI) Medications can assist with intubations and are used in patients who are agitated with altered mental status or who have a difficult airway or for patients undergoing surgery.

3. RSI Protocol 100% O2 preoxygenate  IV sedative  rapid IV succinylcholine/paralytic  stop bag-valve-mask ventilation  intubate with apnea onset  auscultate breath sounds, ET CO2  secure tube, provide additional paralysis, sedative as needed

4. Analgesics: Fentanyl, morphine sulfate –Added after intubation Atropine –For children < 10 y.o., adults with bradycardia, or those receiving 2nd dose of succinylcholine Lidocaine –Given 1 min before intubation

5. Paralytics Short acting: succinylcholine, vecuronium, rocuronium Longer acting: pancuronium

6. Neuromuscular Blockers Fx

7. Sedatives Propofol Etomidate Midazolam –Short-acting benzodiazepine Fentanyl (also analgesic) –Short-acting narcotic Ketamine (also analgesic) –Dissociative anesthetic agent

8. References Stone, C Keith, et al (2008). Current Diagnosis & Treatment: Emergency Medicine, 6e. Ohio: The McGraw Hill Companies, Inc. Tintinalli, Judith E, et al (2011). Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e. Ohio: The McGraw Hill Companies, Inc.

9. Thanks to... The Tulane Anesthesia teams My fellow classmates