List Archives

Thu Aug 2 11:33:45 BST 2007

No black Box per Epocrates (checked just now) and this would have been all
over the net and on multiple daily medical news services I subscribe to, so
am 99.99999% certain, no black box as of 1330 Egypt time, anyway.

Lorick

Lorick Fox, MPAS, PA-C
Gianaclis Support Complex, Egypt
+203-448-2335
Fax +203-448-2339
Mobile +20-18-230-4448

> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-
> bounces at trauma.org] On Behalf Of Hardcastle, Tim, Dr <tch at sun.ac.za>
> Sent: Thursday, August 02, 2007 12:56 PM
> To: Trauma &amp; Critical Care mailing list
> Subject: RE: Etomidate
> 
> BFM
> 
> Correct in sepsis - the evidence in trauma is miniscule - this is my
> issue!
> 
> Tim
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Blueflightmedic
> Sent: Thursday, August 02, 2007 10:15 AM
> To: trauma-list at trauma.org
> Subject: Re: Etomidate
> 
> 
> Firstly congratulations to all those who responded so magnificently in
> Minneapolis. Condolences to the bereaved. The news broke here in the UK
> at 1 AM just as I was returning home from dealing with a very nasty
> head-on RTC; three serious, 1 died in my hands on scene from massive
> haemorrhage - probably ruptured liver.
> 
> Etomidate is rapidly becoming a drug to avoid because of its prolonged
> suppressant effect on the adrenal response. We though initially that it
> was only infusions that caused the problem but there is now good evidence
> that a single induction dose of etomidate causes problems for some days,
> and patients with multiple trauma or severe sepsis do not need adrenal
> suppression. We scarcely ever use it now.
> 
> 
> > *From:* "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za>
> > *To:* "Trauma-List (E-mail)" <trauma-list at trauma.org>
> > *Date:* Thu, 2 Aug 2007 07:11:01 +0200
> >
> > Hi all
> >
> > A query regarding Etomidate: there is a rumour spreading around
> > South Africa that Etomidate has been "black-boxed" by the FDA and
> > this includes a warning to not use it for RSI. I have been unable
> > to confirm this on their website, but maybe I don't have adequate
> > access. Any list member out tere form the USA who can confirm /
> > deny / give the correct details, so we can give clear guidelines -
> > we still use Etomidate for our RSI in NON-SEPTIC patients (i.e.
> > acute trauma).
> >
> > My reading of the literature does not support avoiding of Etomidate
> > in trauma, with only one study in head trauma suggesting a possible
> > link.
> >
> 
> BFM
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Etomidate