The only premedication required for any prehospital rapid sequence induction
is oxygen.
BW
R
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Andrew Webster
Sent: 16 May 2010 07:13
To: [log in to unmask]
Subject: Re: RSI - pre-medication
No to lidocaine.
Yes to fentanyl
Andy
On 16 May 2010, at 02:27, Jel Coward <[log in to unmask]> wrote:
> Hi all
>
> <Quoting>
> Available data show that these agents are used much
> more frequently in the United States (US) than in the United
> Kingdom (UK). Interestingly, this difference in practice
> pattern prompted much of the research done in this area.
> A survey of US emergency medicine residency program
> directors done in 1995 illustrated that of the programs that
> responded, 87% used lidocaine, 81% used defasciculation,
> and 49% used fentanyl when performing RSI in adults with
> elevated ICP.1 In a UK review of 60 emergency intubations, of
> which only 26% were performed by emergency physicians, no
> patients received lidocaine or defasciculation.2 This variation
> in practice patterns exemplifies the lack of consensus opinion
> and evidential support.
> </Quote>
>
> I would be interested in views on
>
> 1. lidocaine as pre-med for RSI in the head injured patient.
> 2. fentanyl for the same
>
> Are they commonly used in the UK/places other than N America?
>
> How many folks would consider them routine for RSI in this
> circumstance?
>
>
> Thanks for any replys :)
>
> --
> Jel
> Visit the OSCAR Canada Users Society
> http://OSCARcanada.org
> and learn about a world leading open-source Electronic Medical Record
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