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Atropine - Rapid Sequence Intubation
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Atropine - Rapid Sequence Intubation

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#respiratory
Publish Date: April 21, 2017
Table of Contents

Introduction

Atropine is an anticholinergic agent which is commonly used in the Emergency Department for the treatment of bradycardia and organophosphate poisoning, but may also be used as an adjunct for Rapid Sequence Intubation (RSI) in the pediatric population.  Atropine is commonly used when performing Rapid Sequence Intubation in children less than 10 years old, secondary to the reflex bradycardia which typically develops with pediatric intubations. Atropine also has a secondary benefit in which it dries secretions and may improve your field of view during your intubation. 

Pharmacology

Atropine works by blocking Acetylcholine, the primary neurotransmitter released by the Vagus nerve on the heart, increasing cardiac output.

Dosing

The typical dose for atropine is 0.02 mg/kg/dose with a max single dose of 0.4 mg and a minimum dose of 0.1mg. Doses less than 0.1mg have been associated with paradoxical bradycardia.

Adverse Effects & Contraindications

There are few contraindications to Atropine. Atropine is contraindicated in patients predisposed to narrow angle glaucoma as it causes pupillary dilation and may increase pressure within the eye. Common side effects of atropine include tachyarrhythmias, nausea, visual changes, and hallucinations.

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