Etomidate
RSI induction, Procedural sedation
Indications
- RSI induction
- Procedural sedation
Adult dosing
- rsi: dose: 0.3; unit: mg/kg; route: IV; weightBased: true; maxDose: 60; maxDoseAbsolute: true; sedation: dose: 0.1; maxDose: 20; maxDoseAbsolute: true; unit: mg/kg; route: IV; weightBased: true
Pediatric dosing
- rsi: dose: 0.3; unit: mg/kg; route: IV; weightBased: true; maxDose: 60; maxDoseAbsolute: true; pedNote: Use in children >10 years; use ketamine for younger children
Contraindications
- Adrenal insufficiency
- Septic shock (relative — single dose likely safe)
Clinical pearls
- Most hemodynamically neutral induction agent — ideal for unstable patients
- Single dose adrenal suppression lasts ~12 hours — clinical significance debated
- May cause myoclonus — not seizure activity, but can complicate neuro exam
- Avoid in septic shock if possible — consider ketamine instead
Source and review
- Tintinalli's Emergency Medicine, 9th ed.. Last reviewed: 2024-10-15