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Tue Sep 21 15:09:17 BST 2004

In a message dated 21-Sep-04 05:20:50 Central Daylight Time, 
paul.middleton at usa.net writes:
Having moved from the UK to Australia, where etomidate is not available, I
have rediscovered the skills of using these agents in shocked patients,
particularly in the field where intubation of patients under a tree or on
the back of a boat (!) makes life even more interesting. 
Yep...working out in the field in the mud and the blood is a bit different 
from having a nice clean dry ED with hot and cold running residents, isn't it?

As a final word, what about ketamine for induction. To use it is to love it!
Again, not the sort of thing that I routinely have available in a small town 
ED here in Louisiana. Part of the problem is that many small EDs do have a 
fair percentage of moon lighters to maintain any sort of coverage, and the 
variability of the skill levels hurts those of us who are willing to do additional 
study and training.

Charles S. Krin, DO

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