RE: Management of Aortic Emergencies

["Loyd Helmick" <loyd_helmick@mediplane.com>]

Hi Allan,
  We try to do these calls hot, since time is of the essence.  We will use
MSO4 and versed for pain and anxiety. We start Esmolol a beta blocker to
keep the HR and BP low.  We start at 50mcg/kg/min and double every 2-3"
until we max at 300mcg/kg/min.  We titrate for a MAP of 60-80.  If MAP still
>80 then we start Nipride, but be cautious since it will now be potentate
with the Esmolol.  We don't use Nipride by itself, because if you start
Nipride, the bodies bauro receptors sense a low perfusion and increase the
HR to compensate.  Thus you increase the shearing force.
If you want more specifics let me know.

Loyd Helmick
REACH

loyd_helmick@mediplane.com

-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On Behalf Of Wildmedic17@aol.com
Sent: Saturday, December 28, 2002 10:19 AM
To: flightmed@flightweb.com
Subject: Management of Aortic Emergencies


 Does anyone on the list have any protocols or guidelines for the
pharmocological management of a patient with an acute aortic emergency
(dissection, leaking aneurysm, etc.) during transport?

 What are your current practices, ie: what meds do you use to control
hypertension, what SBP/MAP do you shoot for, what do you use for pain
control and sedation, etc.?


Thanks,

Allan Bulkley
Flight Paramedic

_______________________________________________
Flightmed mailing list
To unsubscribe or change your email address, go to
http://www.pairlist.net/mailman/listinfo/flightmed


_______________________________________________
Flightmed mailing list
To unsubscribe or change your email address, go to http://www.pairlist.net/mailman/listinfo/flightmed