Re: Sedation vs. sedation/paralysis

["Slemp, Andrew A." <ASlemp@mc.utmck.edu>]

Greetings from Knoxville.

Our crews have the option of Etomidate or Versed for sedation during
induction and routinely use Versed after confirmation of tube placement.
Crews have reported using Etomidate alone for induction, but have seen the
need for Succinylcholine on occasion secondary to incomplete relaxation
and/or laryngospasm.  Etomidate is most often used by our program with
trauma patients, due to the low incidence of hemodynamic effects.  Versed is
usually employed for isolated CHI and medical patients.  We also have the
option of skipping the administration of Lidocaine when using Etomidate
because of its reported blunting effects of ICP increase during intubation.

I'm not sure about the issue of refrigeration for Etomidate.  The two
programs I've flown with did not refrigerate it.

In regards to ventilator patients, we routinely sedate and paralyze the
patient for transfer.  We do try to manage our NMB administration to allow
for evaluation at the receiving facility when possible, but like other
postings, patient and crew safety are our priority as well.

Drew

Andrew Slemp, EMTP, FP-C
UT LIFESTAR
Knoxville, TN  

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