EMS World

OCT 2015

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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AIRWAY MANAGEMENT AGENT STANDARD DOSE (MG/KG) DOSE IF HEMODYNAMIC COMPROMISE COMMENTS Etomidate 0.2–0.3 0.1–0.2 Rapid onset, short duration. Few hemodynamic efects. Preferred for hypotensive patients with head injury or coronary artery disease. Ketamine 1.0–2.0 No diference Longer duration. Sympathetic stimulation, bronchodilation, dreams, salivation. Preferred for patients with asthma. Propofol 2.0–2.5 mg/kg given 40 mg every 10 seconds No diference Slow injection preferred over rapid bolus administration. Rapid bolus may result in cardiorespiratory depression. Titrate dose to response. Maintenance doses by infusion are preferred: 0.3–3 mg/kg/hr for prolonged sedation. Avoid in patients with hypovolemia. Fentanyl and midazolam Fentanyl 1.0–4.0 mcg/kg for pain; midazolam 5.0–10.0 mg for sedation Reduce by 50% if hemodynamically compromised Can cause respiratory depression during initial administration. Excellent for prolonged sedation and pain control, but monitor vital signs often. Succinylcholine 0.6–1.5 No diference Short-acting. Many contraindications and adverse efects. Clinical duration 4–6 minutes. Rocuronium 0.6–1.5 No diference Onset time equal to succinylcholine. Clinical duration 30–60 minutes. Vecuronium 0.08–0.10 No diference Onset time 2–3 minutes. Clinical duration 25–40 minutes. TABLE 1: IV INDUCTION AND NEUROMUSCULAR BLOCKING DRUGS FOR RSI/DSI 52 OCTOBER 2015 | EMSWORLD.com WE'RE COMING TO NEW ORLEANS SAVE THE DATE October 3 – 7, 2016 Ernest N. Morial Convention Center | New Orleans, LA EMSWorldExpo.com #EMSWorldExpo2016

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