>>> [log in to unmask] 04/25/01 07:50 >>>
>Half strength thio is often used in such patients and
>if IV access has been established then hypovolaemia or
>sudden drops in pressure can be avoided, also a
>syringe of ephedrine is kind of an expected.
Iain,
I would have thought mentioning vasopressor use and unresuscitated hypovolaemia in the same sentence is bravely opening a can of worms :-). I appreciate there is a theory that its appropriate to correct drug induced hypotension with another drug - but there is a strong argument that in hypovolaemia that it is best to avoid any vasopressors until they are fully resuscitated. If you have to have a vasopressor on hand routinely during induction with ½ thio then perhaps there are better options - I agree that its what is within your comfort zone and experience - but I would suggest that while Etomidate can cause hypotension, it is considerably more cardiostable than thio, and the chances of needing a vasopressor are much lower. Any thoughts ?
Craig
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