- 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).