RE: Sedation vs. sedation/paralysis

["Tom Waters" <tom@tomwaters.net>]

Rules on storage vary greatly between pharmacists, technically Sux is
s'posed to be served chilled, but we don't, nor do we keep the etomidate
there.  We do store the Ativan in the chiller, whereas no-where else I
had ever been did they.
It really seems to be up to the local thought process.

At the first ground service I worked for, we had sux, and it was kept in
our lock-box on the rigs, with the narcs.  It was rotated out every
month (it's cheap) and funny thing was, on expiration day, we took it
out of the lockup, put it in returns bin of stuff that was picked up by
the LT's to go back to central supply; it was just lying there for
anyone to take (not that it is controlled, just "dangerous")

Tom

-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com] On Behalf Of GBSimons@aol.com
Sent: Thursday, October 03, 2002 14:32
To: flightmed@flightweb.com
Subject: Re: Sedation vs. sedation/paralysis


Hello All!
       First of all, etomidate is great stuff, for all the reasons
already 
mentioned. Check on how to store it. I believe it has to be
refrigerated, and 
I'm not sure how long it is good once removed from the refrigerator.
       We keep most of our patients sedated and paralyzed after RSI.
This is 
accomplished mainly by repeated boluses of versed and vecuronium. With
our 
flight times of 30 to 60 minutes, this works well for us. Every now and
then 
I get a patient who, after being intubated, is so weak that their body
seems 
to be quite happy to let the ventilator do the work. These patients seem
to 
ventilate well with a little sedation and no paralytic. These are also
the 
type of patients who are not combative or restless. (I actually worry a
bit 
more about this type of patient. Their body seems to be giving up. I'd
rather 
see a little fight left in them.)

George Simons, RN, MS, FNP-C
Flight Nurse
Life Net Arizona
Tucson, Arizona

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