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Medical References
Adult airway medication reference
Static educational ranges. This page does not accept a weight or calculate total dose, medication volume, concentration, or pump rate.
Hemodynamic context matters: ACEP’s January 2026 adult ED intubation policy supports ketamine or etomidate to reduce peri-intubation hypotension risk and advises against treating fentanyl, midazolam, or propofol as induction/coinduction defaults in patients at increased hypotension risk.
Induction and neuromuscular blockade
| Medication | Weight-based reference | Context and cautions |
|---|---|---|
| Etomidate | 0.3 mg/kg IV | FDA-labeled adult induction reference. Consider a lower dose in older or physiologically fragile patients according to local practice. |
| Ketamine | 1–2 mg/kg IV | Common emergency-intubation induction range. Individualize to physiology and administer deliberately. |
| Rocuronium | 1–1.2 mg/kg IV for RSI | Common ED RSI range within the FDA-labeled 0.6–1.2 mg/kg range. Ensure adequate anesthesia, sedation, and ventilatory support. |
| Vecuronium | 0.1 mg/kg IV | Longer-onset nondepolarizing alternative in some protocols. Verify expected onset, duration, reversal strategy, and local use. |
| Succinylcholine | 1–1.5 mg/kg IV | Common emergency RSI range. Screen for hyperkalemia risk, neuromuscular disease, malignant-hyperthermia susceptibility, burns/crush injury timing, and other contraindications. |
Post-intubation analgesia and sedation references
| Medication | Weight-based reference | Context and cautions |
|---|---|---|
| Fentanyl bolus | 1–2 mcg/kg IV | Analgesia reference. Titrate carefully; respiratory depression, chest-wall rigidity, and hypotension are possible. |
| Propofol infusion | 5–50 mcg/kg/min IV | Start low and titrate. Avoid reflexive boluses or escalation in hypotension; use the minimum effective dose. |
| Ketamine bolus / infusion | 0.5–1 mg/kg IV bolus; 0.5–1 mg/kg/hr infusion | Common off-label post-intubation reference. Verify local formulary, monitoring, and analgesia strategy. |
| Midazolam bolus / infusion | 0.02–0.05 mg/kg IV bolus; 0.04–0.2 mg/kg/hr infusion | Accumulation and hypotension can occur. Midazolam is not an analgesic. |
| Dexmedetomidine infusion | 0.2–0.7 mcg/kg/hr | Not an adequate sole agent immediately after paralysis. Bradycardia and hypotension may occur. |
These are starting-reference ranges, not orders. Match analgesia and sedation to physiology, prior medications, organ function, age, obesity strategy, hemodynamics, target depth, and local pharmacy policy. Never leave a paralyzed patient without adequate analgesia and sedation.
Primary sources and update anchors
ACEP: Critical Issues in Adult ED Endotracheal Intubation (January 2026)NIH DailyMed drug labelsAbout this resource
Created by: Kyle Brown MD; Andrew Pirotte, MD; Reba Hodge, MD; Amanda Vanderwerf, PharmD, BCEMP; Morgan Kimball, PharmD, BCEMP; Joshua Mohess
Clinical review: EM faculty Reviewed: local ED, ICU, EMS, anesthesia, pharmacy, and pediatric protocol review recommended before bedside teaching rollout.
Last reviewed: 2026-07-23
Next scheduled review: 2027-01-23
Designed for: EM residents, emergency physicians, EMS clinicians, airway educators, and simulation faculty
Important: Educational resource and clinical-reference guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.
Website contact: kybrown@kumc.edu