Emergency Anaesthetic drugs for severe trauma.

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John

We have not previously pre-drawn up drugs for our 80 or so RSIs per year but are currently considering doing so. We usually find that the time from the ambulance notification or the time required for proper pre-oxygenation gives enough time for the intubation drugs to be prepared (invariably etomidate and sux for intubation and propofol/atracurium for maintainance). However we are worried about the delays caused by the controlled drugs (predominantly alfentanil or fentanil pre-treatment for head injuries) as this requires 2 staff to check and get out from the CD cupboard. We are considering having a full set of drugs drawn up and labelled every morning in a sealed container in the fridge for RSIs (etomidate, suxametonium, atracurium, morphine and fentanil or alfentanil). However if we do this then we are throwing away about £800.00 of drugs a year - not inconsiderable.

Phil Munro
Emergency Medicine
Glasgow

Midazolam (versed) for RSI? - Yuck!


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