According to the SFAR-SRLF joint guidelines, which medications should be used during the performance of rapid sequence intubation?

Updated: Apr 07, 2020
  • Author: Keith A Lafferty, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Hypnotic agents (eg, etomidate, ketamine, propofol) facilitate rapid sequence induction. The choice of agent depends on patient history and clinical situation.

Succinylcholine can be used in critically ill patients to facilitate tracheal intubation during rapid sequence induction. If succinylcholine is contraindicated, rocuronium dosed above 0.9 mg/kg (1-1.2 mg/kg) is an alternative. Note that sugammadex should be available for possible emergent use if rocuronium is used.

An additional recommendation for pediatric patients is the use of atropine before intubation and during induction for those older than 28 days up to age 8 years, particularly in children with septic shock or hypovolemia or if suxamethonium is used.


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