Rapid Sequence Intubation Calculator

Rapid sequence intubation dosing here follows standard weight-based emergency airway protocols: every drug dose scales linearly with patient weight, but which drug is chosen changes the multiplier dramatically. Etomidate at 0.3 mg/kg is the calculator's default induction agent because of its relative hemodynamic stability, while ketamine and propofol are both dosed at 1.5 mg/kg -- five times etomidate's per-kilogram dose -- with ketamine generally preferred when hemodynamic support is a priority and propofol favored when rapid, predictable offset matters more. Paralytic choice carries a smaller but still meaningful difference: succinylcholine at 1.5 mg/kg versus rocuronium at 1.2 mg/kg, the higher "RSI dose" of rocuronium specifically chosen so its onset approaches succinylcholine's when succinylcholine is contraindicated (such as hyperkalemia, recent major burns, or neuromuscular disease). Lidocaine (1.5 mg/kg) and fentanyl (2 mcg/kg) pretreatment doses, both optional and given roughly three minutes before induction, scale with weight alone and do not depend on which induction agent or paralytic is chosen.

Note that lidocaine pretreatment's evidence base has weakened in more recent literature -- some departments have moved away from routine use for indications like elevated intracranial pressure -- so treat it as an optional, protocol-dependent step rather than a universal standard. All weight-based doses here use total body weight; for markedly obese patients, some centers dose induction agents and paralytics by lean or ideal body weight instead -- follow local protocol if TBW dosing seems excessive. Endotracheal tube size follows the standard age-based pediatric formula for a cuffed tube (age in years divided by 4, plus 3.5, per Duracher's 2008 refinement of the earlier Khine formula, adopted in AHA PALS 2020) up to age 16, then a fixed adult default of 7.5 mm; tube depth at the lip is estimated as three times the tube's internal diameter for anyone past the neonatal window (age 0.25 years / 3 months and weight 4 kg), and as weight in kilograms plus 6 for neonates below that window. None of the tube-sizing outputs depend on patient weight (outside the neonatal depth rule) or on which induction or paralytic agent is selected.