Tracheal Intubation Medications

Excerpt

Endotracheal intubation is indicated in many clinical settings, such as impending respiratory failure and when protecting the patient airway. The following describes the most common medications used for rapid sequence intubation of the pediatric patient in an emergency setting. It represents a reasonable approach for individuals who are not anesthesia or critical care specialists. The process of endotracheal intubation is not reviewed; however, the following are a few critical points regarding the procedure. In most cases, endotracheal intubation is a semi-urgent procedure. Commonly used premedications including fentanyl, midazolam, and atropine; induction agents including etomidate and ketamine; paralytics including rocuronium and succinylcholine; and reversal agents including naloxone, flumazenil, and paralytics are reviewed. This activity outlines the indications, mechanism of action, methods of administration, important adverse effects, contraindications, toxicity, and monitoring, of agents used to facilitate tracheal intubation, so providers can direct patient therapy where they are indicated as part of the interprofessional team.