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Intubation and Sedation Medications

 

Drug

Dose

Comment

Sedation

Fentanyl

5 mcg/kg dose IV
(max 100 mcg/dose)

Administer over 3-5 minutes to avoid chest wall rigidity

 

Midazolam

0.05-0.1 mg/kg/dose IV (max 2 mg)

May use as adjuvant for sedation with above medications
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

Adjuvant

Atropine

0.02 mg/kg IV

(minimum dose 0.1 mg)

Only for bradycardia

 

Glycopyrrolate

4-10 mcg/kg IV
(max 0.3 mg/dose

For bradycardia or to control secretions


Reconceptualized from: http://www.chop.edu/clinical-pathway/severe-sepsisseptic-shock-icu-clinical-pathway-infants-28-days-and-children-1

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.