RSI Dosing Cheat Sheet: Calculate Sedation & Paralysis in 5 Seconds

In emergency medicine, every second counts—especially during RSI. There’s no time for app fumbling or frantic formula hunting. Here's your practical, memorable, and clinically relevant guide to dosing RSI dosing confidently and accurately, every time.

The Essential RSI Medications

Let’s simplify the complex:

Sedatives

Ketamine: 1.5 mg/kg IV (approx. 0.7 mg/lb)
Propofol: 2 mg/kg IV (approx. 0.9 mg/lb)
Etomidate: 0.3 mg/kg IV (approx. 0.14 mg/lb)

Paralytics

Rocuronium: 1.2 mg/kg IV (approx. 0.55 mg/lb)
Succinylcholine: 1.5 mg/kg IV (approx. 0.7 mg/lb)

Quick Tricks:

Ketamine & Succinylcholine: Think "weight × 1.5"
Propofol: Easy as "weight × 2"
Etomidate: Approximate as "weight ÷ 3"
Rocuronium: Slightly more than your patient’s weight

Practical Pitfalls (and How to Avoid Them)

Incorrect Weight Estimates: Always use an actual measured weight if possible—estimating can lead to significant dosing errors.
Drug Confusion: Clearly label your syringes and verbally confirm doses, especially with similar-sounding drugs like rocuronium and succinylcholine.
Rapid Calculation Errors: When rounding doses, always round to the nearest 5 mg increment for practicality and safety.

Tube Sizing & Depths at a Glance

Avoid the common pitfalls of incorrect tube sizing by using these easy rules:

Pediatric Uncuffed ETT: (Age ÷ 4) + 4 mm
Pediatric Cuffed ETT: (Age ÷ 4) + 3.5 mm
Adult Cuffed ETT: Typically 7.5–8.5 mm
Depth at Lips: Tube size (in mm) × 3 = depth in cm

Handy Hint: Tape a quick-reference table on your airway cart or keep it digitally accessible on your lock screen.

Why a Pocket Cheat Sheet is Your Best Ally

Instant Access: Skip the app launches and scrolling—vital information is always at hand.
Error-Proof: Pre-calculated doses minimize the chance of dosing errors under pressure.
Always Ready: Ideal for keeping behind your ID badge or instantly accessible on your device.

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