RSI meds

Specialties Emergency

Published

out of curiosity...

what meds do your docs like to use for RSI. anybody using ketamine, read that it can be useful in hypotensive pt.s and especially with status asthmaticus.

Specializes in ER/PDN.

we use etomidate and sux on just about everybody as well. Once intubated, we give norcuron, versed and occasionally (for trauma pts especially)fentanyl.

just my 2cents

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in the EMS service i work with we have a choice of either versed/fentynal or etomidate then succs. We use lido for ^ICP and atropine to blunt brady in peds.

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Specializes in SICU-MICU,Radiology,ER.

Fentanyl is a wonderful drug

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Fentanyl is a wonderful drug

Yup. esp. for us Medics :) , Before My service got Fentynal I would give morphine then the docs would complain that they cant do a motor sens. exam. Now with fentynal the anelgesia is more potent and shorter acting. Also has less adverse hemodynamic effects.

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I agree that lidocaine is a great drug, but may not always be the best choice with cerebral injury.

Lidocaine preferentially blocks inhibitory pathways centrally and may invoke excitatory phenomena (i.e. seizures) at clinical doses thus increasing CRMO2 which could accentuate apoptosis and cerebral edema. There are several articles from the neuroanesthesia department at Barnes-Jewish in St. Louis that describe this event very well.

Mike

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I agree that lidocaine is a great drug, but may not always be the best choice with cerebral injury.

Lidocaine preferentially blocks inhibitory pathways centrally and may invoke excitatory phenomena (i.e. seizures) at clinical doses thus increasing CRMO2 which could accentuate apoptosis and cerebral edema. There are several articles from the neuroanesthesia department at Barnes-Jewish in St. Louis that describe this event very well.

Mike

Therapeutic Drug Monitoring: Volume 22(3) June 2000 pp 320-322

Lidocaine and Seizures

DeToledo, John C.

Department of Neurogy, University of Miami, Miami, Florida, USA

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Specializes in MICU.

You can't fix dead. & "vomidate."

Kevin,

I like your choice of words: "you can't fix dead". :chuckle Pearls of wisdom to remember. Mind if I quote you?

lifeLONGstudent

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