JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for ACAD-AE-MED Archives


ACAD-AE-MED Archives

ACAD-AE-MED Archives


ACAD-AE-MED@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

ACAD-AE-MED Home

ACAD-AE-MED Home

ACAD-AE-MED  April 2001

ACAD-AE-MED April 2001

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

Re: Scenario - Intubation and IV access

From:

Craig Ellis <[log in to unmask]>

Reply-To:

The list will be of relevance to all trainees including undergraduates and <[log in to unmask]>

Date:

Tue, 24 Apr 2001 09:07:21 +1200

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (37 lines)

>>> [log in to unmask] 04/23/01 11:59 >>>

>I would never resort to IM ketamine or IM sux for this patient who has to be
>assumed to have a major head injury as well.

Colin,
 
I don't agree (obviously), the risk of a transient rise in your ICP, which has by no means been clearly shown to be a resl clinical problem with Ketamine, is off set by the fact that this guys hypoxia is rapidly knocking off neurons and I think Ketamine is justified as part of what I see as one of the few practical induction options available to you.

>IM Sux (or IV Sux) alone in this setting is not only dangerous but inhumane.

I agree that its probably inhumane and I would you a sedative / induction agent, but I wouldnt call it dangerous - anything you do to this guys airway is going to be fairly high risk - what specifically are you worried about here ? The main risk I see is further collapse of the upper airway secondary to loss of muscle tone with paralysis.

I think Darren is right, there is clearly 2 schools of thought regarding at what point it becomes acceptable to use muscle relaxation alone - I say hardly ever and never at GCS 7, but there are others around who would for a variety of reasons.

Everything that is going on in this situation is going to be pushing his ICP up - he's struggling and he's hypoxic - I dont believe that a crash induction in this situation is going to make things worse and is certainly medically defendable.

>What has happened to the primary surgical airway?

Certainly its a definite option, but again with GCS 7 and thrashing around your still looking at having to give him something


Craig
EM registrar, New Zealand



CCH Secure Mail Server
********************************************************************************
This email or attachment(s) may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Capital Coast Health Ltd. (AC_S001)


[INFO] -- Virus Manager:
No Viruses were detected in this message.

********************************************************************************

Top of Message | Previous Page | Permalink

JiscMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

March 2024
February 2024
January 2024
December 2023
November 2023
October 2023
September 2023
August 2023
July 2023
June 2023
May 2023
April 2023
March 2023
February 2023
January 2023
December 2022
November 2022
September 2022
July 2022
February 2022
January 2022
October 2021
September 2021
August 2021
June 2021
May 2021
April 2021
March 2021
April 2020
March 2020
February 2020
September 2019
March 2019
April 2018
January 2018
November 2017
May 2017
March 2017
November 2016
February 2016
January 2016
December 2015
August 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
October 2014
September 2014
July 2014
June 2014
May 2014
April 2014
February 2014
December 2013
November 2013
October 2013
September 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
May 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998


JiscMail is a Jisc service.

View our service policies at https://www.jiscmail.ac.uk/policyandsecurity/ and Jisc's privacy policy at https://www.jisc.ac.uk/website/privacy-notice

For help and support help@jisc.ac.uk

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager