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Mon Oct 10 07:40:14 BST 2005

I have never believed lidocaine did anything but numb the administrator's
sensibility. Any ICU nurse who has watched a patient's ICP rise when they
suction the tracheal tube can tell you that the secret to preventing a rise
of ICP when intubating is deep and long paralysis. Thus, when intubating a
comatose head-injured patient, I use 20 mg of vecuronium and deeply paralyze
them before intubation. Occasionally (if they are posturing), I will wage a
receptor war and give some opiate, benzodiazepine, and H-1 blocker - it
slows the heart rate and decreases BP very gently.

Lidocaine is another one of those non-evidence-based things we do because
every one else does. 

DB
bensonblues at comcast.net

-----Original Message-----
From: Mike MacKinnon [mailto:mmackinnon at cox.net] 
Sent: Sunday, October 09, 2005 1:53 PM
To: Trauma & Critical Care mailing list
Subject: Opinion on the list in regards to Lidocaine in head injury pre RSI

Question for the group

After reviewing the research it seems there is no proof that lidocaine has
any benefit as an ICP blunt pre RSI. 

( I attached a few of the smaller articles referenced)

What are the opinions of the listserve members on this topic? 

Is there any risk associated with giving lidocaine?

It is currently in the majority of protocols pre hospital, should this be
changed or not?

thanks for your consideration

Mike MacKinnon CEN CFRN BSN RN

"I reject your reality and substitute it with my own!"

mmackinnon at cox.net

-------Original Message-------

From: Krin135 at aol.com

Date: 10/09/05 10:45:08

To: trauma-list at trauma.org

Subject: Re: head CT

trauma-list : TRAUMA.ORG

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Opinion on the list in regards to Lidocaine in head injury pre RSI