2 mcg/kg dose IV
(max 100 mcg/dose)
0.5-2 mg/kg/dose IV0.05 mg/kg/dose IV
Administer over 3-5 minutes to avoid chest wall rigidity
May start with smaller doses when needed (i.e., patients with cardiac dysfunction)May use as adjuvant for sedation with above medications
Use with caution in catecholamine refractory patients as may cause hypotension
May cause increased secretions, consider using with glycopyrrolate (see below)
Use with caution in hypotensive patients
|Neuromuscular Blockade||Rocuronium||1.2 mg/kg/dose IV
(max 120 mg/dose)
|To be given once patient is adequately sedated (if not rapid-sequence intubation)
For alternative agents to achieve neuromuscular blockade, please see Formulary
0.02 mg/kg IV4-10 mcg/kg IV
(minimum dose 0.1 mg)
(max 0.2 mg/dose)
For bradycardia or control of secretions with ketamine inductionFor bradycardia or control secretions with ketamine induction
Etomidate is NOT recommended due to concern for adrenal suppression, possible association with mortality.
If patient is intubated and sedated for more than several hours, consider continuous sedation.
For patients with persistent shock and hypoxemia, consider continuous NMB to decrease oxygen demand.