Re: Sedation vs. sedation/paralysis

[Wildmedic17@aol.com]

       Etomidate is great - much quicker and more predictable than versed or 
valium. I have occasionally foregone the sux after the etomidate takes effect 
and intubated with the sedation alone - it often works that well. We always 
paralyze (with norcuron) after ET placement confirmation, though - it's a 
matter of patient safety. I honestly can not think of any practical "cons" to 
etomidate - not that I've ever seen personally, anyway.  
      
       We will occasionaly tx a sedated pt who is not paralyzed, though not 
usually. Again, this is a matter of safety - you dont want the patient waking 
up and dislodging the ET if the sedation wears off. My favorite drug for this 
role is definitely propofol.

       Good luck.

Allan Bulkley
NREMT-P, CCEMT-P, FP-C
Flight Paramedic, Mercy Flight of WNY      


<<The flight srvice I work for is in the process of our yearly protocol
revisions.  Several questions have been brought up regarding the use of
sedation and paralysis of intubated patients.

I would like to find out if other services rotuinely use paralytics on
all intubated pt.s, along with sedation, or is sedation alone enough if
the pt. is not "fighting" the ventilator. 
Also, we are looking at adding Etomidate to our protocols, in addition
to the Versed/Mivacron we use presently.  If any other services are
using Etomidate, what are some of the pros/cons of this drug.

Thank you very much,
John Smith, RN
AeroCare
Lubbock, Tx.>>



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