Sedation Agents
Choose the appropriate sedative based on the patient’s condition and potential side effects:
Midazolam
- Dose: 0.1 - 0.2 mg/kg
- Ampoule: 5 mg/1 mL
- Administration: Give pure over 5-30 seconds
- Side Effects: Respiratory depression
- Advantages: Does not significantly affect heart rate or blood pressure.
Ketamine
- Dose: 1.5 - 2 mg/kg (bronchodilator)
- Ampoule: 200 mg/20 mL (10 mg/mL)
- Administration: Give pure over 60 seconds
- Side Effects: Hypertension, tachycardia, increased secretions
- Advantages: Useful in asthmatic patients due to its bronchodilation effect.
Etomidate
- Dose: 0.3 mg/kg (cardioprotective)
- Ampoule: 20 mg/10 mL (2 mg/mL)
- Administration: Give pure over 30-60 seconds
- Side Effects: Adrenal suppression (avoid in sepsis)
- Advantages: Minimal cardiovascular effects, ideal for hypotensive patients.
Propofol
- Dose: 1.5 - 3 mg/kg (antiepileptic)
- Ampoule: 10 mg/mL
- Administration: Give pure
- Contraindications: Allergy to soy, egg, or peanut
- Side Effects: Hypotension, reduced cerebral perfusion, myocardial depression.
Paralysis Agents
Choose between a depolarizing or non-depolarizing agent based on clinical needs and duration of paralysis required:
Succinylcholine (Scoline)
- Dose: 1 - 2 mg/kg
- Ampoule: 100 mg/2 mL
- Administration: Given pure as a bolus
- Duration: 5-10 minutes
- Side Effects: Hyperkalemia, malignant hyperthermia, fasciculations, bradycardia
- Advantages: Rapid onset and short duration, ideal for rapid sequence intubation (RSI).
Rocuronium
- Dose: 1 mg/kg
- Ampoule: 50 mg/5 mL
- Administration: Given pure as a bolus
- Duration: 30-60 minutes
- Side Effects: Hepatotoxicity
- Reversal Agent: Sugammadex 16 mg/kg IV (if needed).