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Oct 16, 2003 02:39 AM

etomidate


this recently came up at my local rural ER,
some of the seasoned nurses didn't "feel right" about giving it, but gave it anyways......... for sedation
another nurse piped up and said it is not in our scope of practice to preforme anestheia.......
(etomidate was not in any drug book we had)
so do any of you use etomidate in the ER?
I'm a new grad and would really like to hear some of your experienced thoughts on this. thanks in advance xoxo Jenni


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30 Comments
No. 1
from CougRN
Old Oct 16, 2003, 03:07 AM

We use it in the ICU all the time for intubation. Nurses are allowed to push it.
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No. 2
from 911fltrn
Old Oct 16, 2003, 03:20 AM

Yep, Use it all the time in the e.r. for intubation purposes! If you and your co-workers have any doubt about the ability to manage an airway i wouldnt use. Great presedation prior to paralyzation for intubation. Hmm that kinda rolls off your tongue. Welcome to the R.N. ranks
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No. 3
from ERNurse752
Old Oct 16, 2003, 06:13 AM

We use Etomidate for intubations, as well as a lower dose for sedation in procedures, such as reduction of shoulder dislocations.

We have the pt on a cardiac monitor with continuous pulsox, and O2 and an ambu standing by.

Have never had a problem with it!

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No. 4
from EastCoast
Old Oct 16, 2003, 06:39 AM

Etomidate is a wonderful induction agent especially if you are not anxious about paralyzing a patient for intubation. One of the major benefits is that is not as likely to cause hypotension so it is especially good in the face of shock.

Usual dose is 20-40mg. I have never seen a problem with it and will always prefer it to succylcholine as a first choice.
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No. 5
from Traumsquad
Old Oct 16, 2003, 08:40 AM

I have never used etomidate. We have always used meds such as succs.....versed.
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No. 6
from Coldfoot
Old Oct 16, 2003, 09:50 AM

We use Etomidate for intubations prehospital at the Critical Care Medevac service I work for. Good stuff
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No. 7
Old Oct 16, 2003, 11:53 AM

Originally posted by Traumsquad
I have never used etomidate. We have always used meds such as succs.....versed.

ditto
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No. 8
from EastCoast
Old Oct 16, 2003, 11:59 AM

Succs is not so hot in the face of hyperkalemia or recent neuro event which you may not be likely to know in an emergency.

Versed we use too. But I will use it as afterthought. I am more likely to use etomidate followed by fentanyl.

I think Etomidate is one of those drugs that is gaining popularity and i think you will see it used more and more.
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No. 9
from athomas91
Old Oct 16, 2003, 05:23 PM

you are right in your question - it depends on what you are using etomidate for....
some hospitals do not allow rn's to push etomidate because it is considered anesthesia - IN CERTAIN DOSES.....
however - so is versed....etc....
so - it is a great med because it has a very, very short 1/2 life - therefore it, unlike versed, doesn't require 1-2 hours of monitoring after it is given - it is great for procedures such as reductions and it is wonderful for intubation because it allows the individual to continue breathing on their own yet sedates enough to intubate - unlike succ's which if given causes the airway to collapse increasing the difficulty of intubation and making bagging a pt difficult and at times impossible.
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