etomidate

[TinyNurse, RN]

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

[CougRN]

We use it in the ICU all the time for intubation. Nurses are allowed to push it.

[911fltrn]

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:cool:

[ERNurse752, RN]

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!

[EastCoast]

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.

[Traumsquad]

I have never used etomidate. We have always used meds such as succs.....versed.

[Coldfoot]

We use Etomidate for intubations prehospital at the Critical Care Medevac service I work for. Good stuff:)

[Rena RN 2003, RN]

Originally posted by Traumsquad

I have never used etomidate. We have always used meds such as succs.....versed.

ditto

[EastCoast]

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.

[athomas91]

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.

[neneRN, BSN, RN]

We almost always use etomidate prior to intubation, usually 20 mg. Once in a while we'll use it for conscious sedation, though most docs tend to use brevitol for that.

[zambezi, BSN, RN]

We use etomidate in our CCU prior to intubation...the RN pushes it...