Timing is Everything: Synchronizing Paralysis and Sedation in Rapid Sequence Intubation

April 14, 2025

Overview

Wednesday, June 11, 2025 @ 12:00pm – 1:00pm
Live via Zoom

The practice gap that has been identified is the extended time to post-intubation sedation following rapid sequence intubation. This is due primarly to differences among the pharmacokinetic parameters of commonly used induction agents and NMBAs leading to the potential for patients to experience wakeful paralysis. It is important to understand in practice that patients receiving rocuronium may be paralyzed for an extended period of time depending on multiple factors (dose received, hepatic/renal dysfunction, etc.) and it is not possible to assess for adequate sedation during this time. Also, induction agents generally have a very short duration of action (less than 10 minutes), and it is imperative to administer a second sedative following intubation in a timely manner. Multiple studies have examined the time to analgosedation and/or post intubation sedation following RSI in the emergency department or general inpatient settings. Pappal RD, Roberts BW, Mohr NM, et al. The ED-AWARENESS Study: A Prospective, Observational Cohort Study of Awareness With Paralysis in Mechanically Ventilated Patients Admitted From the Emergency Department. Ann Emerg Med. 2021;77(5):532-544. doi:10.1016/j.annemergmed.2020.10.012

The overall need and educational goal is to bring awareness to the complexity of the relationships between the varying duration of actions of different induction agents and neuromuscular blocking agents. This will be done through a focus on pharmacokinetic parameters and the patient-specific factors that influence them.

Target Audience

Pharmacists in all practice settings.

Learning Objectives

  • Describe the pharmacokinetic properties of the medications commonly used in rapid sequence intubation
  • Describe guideline recommendations on the use of and selection of paralytics and sedatives in patients undergoing rapid sequence intubation
  • Determine how to minimize the risk of wakeful paralysis in patients undergoing rapid sequence intubation
  • Discuss how to develop ways to overcome barriers to achieving adequate post-intubation sedation

Evaluation

All participants will have the opportunity to review the educational sessions and speakers and to identify future educational needs.

Statement of Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Standards for Continuing Pharmacy Education, The University of Rhode Island College of Pharmacy requires that program faculty disclose any relationship (e.g., shareholder, recipient of research grant, consultant or member of an advisory committee) that the faculty may have with commercial companies whose products or services may be mentioned in their presentations. No one involved in the planning of this program has any relevant financial relationships to disclose.

Speakers

Gianni Lazarides, PharmD

Gianni Lazarides received his Doctor of Pharmacy from the University of Rhode Island in 2024. He is now completing a PGY-1 pharmacy residency at Kent Hospital in Warwick, RI. Dr. Lazarides’ career interests include emergency medicine, cardiology, and infectious disease.

CE Credit

Requirements for Credit

Completion of the online modules and program evaluations are required to earn credit. No partial credit is available for this program. Evaluations must be completed at www.uripharmacycpd.org within 60 days.

The University of Rhode Island College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This application-based program will provide 1.0 Contact Hour (0.1 CEU) for pharmacists. UAN: 0060-0000-25-027-L01-P

Release Date: June 11, 2025 Expiration Date: June 11, 2026

 

Registration

Registration for this program is $7

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  • A computer or mobile device with an internet connection and access to Zoom is required to participate in this live webinar. Participants will receive the Zoom link in their registration confirmation email.
  • Login or create an account in URI’s learning management and CE reporting system using your email address and professional license number. Complete all required account set up fields to ensure accurate CE reporting.
  • Select “Available Live Activities” to find the educational activity.
  • Register and proceed to secure online payment (Visa, MC, AMEX, Discover or Electronic Checks accepted). 

Registration Fee & Refund Policy

  • Registration fee for this program is $7.

Technical Requirements for Virtual Attendance

A computer or mobile device with an internet connection – broadband wired or wireless (3G or 4G/LTE).
It is recommended to download the Zoom app (no account sign-up required) before joining the conference.

Virtual Training Consent 

This program will be available in a virtual format. Zoom Video Conferencing will be used to deliver the live streaming session. By registering for this program and attending virtually, you agree to participate in the live portion of the course by using active video and audio feed through your computer or mobile device.