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| In regards to etomidate - it simply rocks as a sedative - Versed,etc many times take way too long to put them to sleep & has a 10% failure rate (i.e. paradoxical reaction) - Etomidate "drops them like a rock" & is remarkably hemodynamically stable, but remember, like most sedatives, analgesics should be concurrently/soon after administered if pain is an issue - Lastly, the sedation vs. sedation/paralysis issue - A couple of years back, one of our peds anesthesiologists came to our team & asked "why are you paralyzing my children on transport?" - Our answer, as most would say, was "because they are moving & I don't want them to rip out their ETT" - She responded with "If you give them enough sedation/analgesics (i.e. etomidate/fentanyl), they will act paralyzed" - We countered with "what about if they are still moving?" She responsed "If they are moving, they are not sedated enough" - Wow... then she pulled out the trump cards - "How do you know if a chemically paralzed patient is seizing, in pain (they are seemingly always tachycardic), posturing, or even worse, awake?" - After several years of just "sedating the heck out of patients" it really does work & they can still respond to pain, still posture, & still tell they are seizing, but they give you no trouble & the reason they are still is because they are sedated/pain free - the only issue with this is picking drugs that are hemodynamically stable & won't drop the BP's with lots of meds, but again, my experience with etomidate & later etomidate/fentanyl during transport has been fabulous Just a thought Scott Scott DeBoer RN,MSN,CFRN Founder: Peds-R-Us Medical Education PO Box 601, Dyer, IN 46311 888-280-PEDS (7337) 219-865-9271 Fax www.peds-r-us.com |