tag:blogger.com,1999:blog-24021163.post7825817943196972279..comments2024-02-18T01:56:38.508-06:00Comments on M.D.O.D.: Etomidate, the "Wonder Drug"911DOChttp://www.blogger.com/profile/06466669111561150174noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-24021163.post-31920919064723755322007-09-21T14:33:00.000-05:002007-09-21T14:33:00.000-05:00I loved plain old Brevital!But I have used Etomida...I loved plain old Brevital!<BR/><BR/>But I have used Etomidate and I think it's a great. Unfortunately, at my current hospital, I am restricted to using Fentanyl/morphine and Versed or Ketamine. I hate the procedural sedation BS.<BR/><BR/>Anesthesia doesn't "feel comfortable" with sedation on 'full stomach' patients...but has no better alternatives. Oh, by the way, they also don't want to come to the ER 24/7 either.<BR/><BR/>In 3 years here, I have only seen one anesthesiologist....his daughter had a laceration.<BR/><BR/>I am trying to get an approved protocol for an array of procedural sedatives including Brevital and Etomidate. I have the literature to support me, but anesthesia "doesn't feel comfortable" discussing the matter until we have capnography in the ED.<BR/><BR/>It gets put in every budget, but somehow falls out of the budget if one of the administrative nurses with a clip board (who can't start an IV) needs a new bidet or something important.erdoc85https://www.blogger.com/profile/06373340227068589953noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-75706250065877342762007-09-15T22:15:00.000-05:002007-09-15T22:15:00.000-05:00My hospital likes morphine and midazolam, but we'r...My hospital likes morphine and midazolam, but we're trying to divert to ketamine, or even propofol - but the gas passers don't like it. When I worked in the ITU we used a lot of etomidate, but there does seem to be a concern here about it's effects on the adrenals; and I think our teaching / training with respect to methods of sedation / RSI has a way to go before coming out from the 'shadow' of the anaesthetistAlex Stokerhttps://www.blogger.com/profile/05645998228285420107noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-89898154195977000242007-09-15T09:52:00.000-05:002007-09-15T09:52:00.000-05:00I drifted away from etomidate due to myoclonus (ag...I drifted away from etomidate due to myoclonus (aggravating while trying to relocate hips), but will start trying it again with versed.<BR/><BR/>I have used ketamine on adults without versed, with no apparent emergence reaction. In fact, the worst emergence reaction I saw was ketamine with versed on a 21 y/o male.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-46041028463213133232007-09-14T12:18:00.000-05:002007-09-14T12:18:00.000-05:00Have never seen it, but I always use a benzodiazep...Have never seen it, but I always use a benzodiazepine with Ketamine..Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-352343402447460472007-09-14T10:18:00.000-05:002007-09-14T10:18:00.000-05:00Love it. At the start of my residency, it was all...Love it. At the start of my residency, it was all fentanyl/versed, towards the end we had moved completely to propofol. Sometimes ketamine for kids. We wern't allowed to use etomidate for conscious sedation, only rsi, not sure why.<BR/><BR/>Since I left, I'm all about the etomidate. They don't go as limp as they do with propofol, so I think reductions are a little tougher, but not having to worry about the bp and airway so much more than makes up for it.<BR/><BR/>I was taught not to give ketamine to adults because of the emergence reactions. Is it really an issue?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-24021163.post-64353646065412908542007-09-13T20:32:00.000-05:002007-09-13T20:32:00.000-05:00I love Etomidate. It's fast acting, has a short h...I love Etomidate. It's fast acting, has a short half life, and given with Versed it's a ear saving drug when you reduce those joints.<BR/><BR/>And afterwards, the patient is oblivious as to what happened.My Own Womanhttps://www.blogger.com/profile/08520236125332553784noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-59147194048146105862007-09-12T20:51:00.000-05:002007-09-12T20:51:00.000-05:00Why? I think Vitamin K is great, but don't see it...Why? I think Vitamin K is great, but don't see it as compared to Vit E..Give us your experiences..We'll all learn something from your knowledge...Oldfarthttps://www.blogger.com/profile/14333534023484494721noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-81965054086734958432007-09-12T20:37:00.000-05:002007-09-12T20:37:00.000-05:00Great drug, but I have to give the nod to ketamine...Great drug, but I have to give the nod to ketamine.shrodingers cathttps://www.blogger.com/profile/04020541322469047041noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-53760702241810286292007-09-12T18:15:00.001-05:002007-09-12T18:15:00.001-05:00from my ems perspective it's a sweet drug. althou...from my ems perspective it's a sweet drug. although there are grumblings about adrenal suppression, no?Roryhttps://www.blogger.com/profile/02571829035126932845noreply@blogger.comtag:blogger.com,1999:blog-24021163.post-45232990534701747922007-09-12T18:15:00.000-05:002007-09-12T18:15:00.000-05:00I love it for short term sedation. Quick, easy, wi...I <I>love</I> it for short term sedation. Quick, easy, with very few adverse hemodynamic effects.Ambulance Driverhttps://www.blogger.com/profile/10175419709184526342noreply@blogger.com