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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

MedicationWeight-based referenceContext and cautions
Etomidate0.3 mg/kg IVFDA-labeled adult induction reference. Consider a lower dose in older or physiologically fragile patients according to local practice.
Ketamine1–2 mg/kg IVCommon emergency-intubation induction range. Individualize to physiology and administer deliberately.
Rocuronium1–1.2 mg/kg IV for RSICommon ED RSI range within the FDA-labeled 0.6–1.2 mg/kg range. Ensure adequate anesthesia, sedation, and ventilatory support.
Vecuronium0.1 mg/kg IVLonger-onset nondepolarizing alternative in some protocols. Verify expected onset, duration, reversal strategy, and local use.
Succinylcholine1–1.5 mg/kg IVCommon 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

MedicationWeight-based referenceContext and cautions
Fentanyl bolus1–2 mcg/kg IVAnalgesia reference. Titrate carefully; respiratory depression, chest-wall rigidity, and hypotension are possible.
Propofol infusion5–50 mcg/kg/min IVStart low and titrate. Avoid reflexive boluses or escalation in hypotension; use the minimum effective dose.
Ketamine bolus / infusion0.5–1 mg/kg IV bolus; 0.5–1 mg/kg/hr infusionCommon off-label post-intubation reference. Verify local formulary, monitoring, and analgesia strategy.
Midazolam bolus / infusion0.02–0.05 mg/kg IV bolus; 0.04–0.2 mg/kg/hr infusionAccumulation and hypotension can occur. Midazolam is not an analgesic.
Dexmedetomidine infusion0.2–0.7 mcg/kg/hrNot 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) DailyMed: Etomidate label DailyMed: Ketamine label DailyMed: Rocuronium label DailyMed: Succinylcholine label DailyMed: Propofol label
About this resource
Created by: Andrew Pirotte, MD; Kyle Brown, MD; Reba Hodge, MD; Amanda Vanderwerf, PharmD, BCEMP; Morgan Kimball, PharmD, BCEMP; Joshua Mohess Clinical review: Emergency medicine faculty review completed. Medication content reviewed by Amanda Vanderwerf, PharmD, BCEMP, and Morgan Kimball, PharmD, BCEMP. 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 cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment. Website contact: [email protected]