• Use to facilitate imaging, allow management of fractures, perform surgical procedures, and perform invasive diagnostic procedures.
  • Preoxygenate for 5 minutes using oxygen mask.
  • Premedicate using the Deep Sedation Protocol, and place an IV catheter.
  • Induce using PROPOFOL 1 mg/kg IV boluses to effect.
  • Intubate with an appropriate endotracheal tube.
    • Most MWDs require a 9-11 mm ID endotracheal tube. Use a cuffed tube.
  • Maintain anesthesia using:
    • ISOFLURANE 0.5-1.5% titrated to effect in 100% oxygen or
    • SEVOFLURANE 2.0-2.5% titrated to effect in 100% oxygen or
    • PROPOFOL CRI 100-300 mcg/kg/min.
  • Manage pain with HYDROMORPHONE 0.1 mg/kg IV boluses, not to exceed 0.2 mg/kg per hour.
  • Monitor appropriately, give IV fluids, and keep the MWD warm (See Ancillary Support in this CPG, and Table 21).