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>Our trauma surgeons are developing a rapid sequence intubation protocol that
>tries to limit the number  of agents used in order to maintain a uniform
>practice. They are very firm on using etomidate as the sedating agent even
>for peds cases. My understanding is that it is not approved for use in
>children less than 12 years of age. Anybody have more experience with
>etomidate and what are you using as a sedating agent if you are worried about
>hypotension?
>How many of you are using Zimuron?
I use etomidate when I am concerned about increased intracranial pressure
and hemodynamic instability.  It is very safe hemodyanmically, and does
not increase intracranial pressure (a concern with ketamine, which I
otherwise use for hemodynamically unstable patients).  I also use
rocurnoium most of the time for my initial neuromuscular blockade.
 
 
Steve Schexnayder, MD
Arkansas Children's Hospital
University of Arkansas for Medical Sciences
800 Marshall St., Slot 900, Little Rock, AR  72202
Phone (501) 320-1845  Fax: (501)320-3188
Email:[log in to unmask]
 
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The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html