>> [log in to unmask] 04/24/01 05:14 >>>
>One thing I can't get over is the apparant obsession
>in PHC by Ketamine. Good analgesic but a poor
>anaesthetic induction agent.
Iain,
In my own defence since I mentioned Ketamine to start with. In my mind if you make the decision to proceed with a drug assisted intubation in this patient without IV access, your only option is a gaseous induction or an IM induction - and you have to do something. If you choose IM your options for induction agents are either midazolam or ketamine - and my choice would be ketamine - I certainly wouldnt call it an obsession - but its appropriate in this situation IMO. Its only my choice in this patient in the absence of IV access, otherwise I agree there are more appropriate agents.
>The thought of sux on it's own is a recipe for
>disaster and likely to land you in court. It will also
>do quite interesting things to your patients potassium
>in this situation and your (and the patients) cardiac
>rhythm. Interesting and horrible unexpected things.
A history of entrapment alone isnt an indication not to use sux is it ? Ive always thought and been taught that sux was fine in the absence of hyperkalaemia, and that the sensitivity people get concerned about in burns, crush and spinal cord injury was delayed, at a minimum of 24 hours - Im open to correction here !
Craig
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